The primary goal of our research is to identify the underlying
cellular mechanisms for lethal heart rhythm disorders. Our approach
to this problem involves both computer modeling and experimental
studies. Simple dynamical models and more complex ionic models
are used to study cellular electrical dynamics in single cardiac
myocytes and in one-, two- and three-dimensional recreations of
cardiac tissue. The models have been developed using data generated
by voltage clamp studies of single canine ventricular myocytes
and by experiments conducted in isolated Purkinje fibers, arterially
perfused canine ventricle and intact dogs. Predictions made by
the computer models are tested experimentally and the resulting
data are used to further refine the models.
Currently, we are testing the idea that the most lethal of heart
rhythm disorders, ventricular fibrillation, is caused by the nucleation
of a spiral wave of reentrant excitation, which subsequently disintegrates
into multiple, self-perpetuating spiral waves. This process is
facilitated by the dynamical heterogeneity of cellular electrical
properties that arises from a steeply sloped electrical restitution
relation (the relation between the duration of the cardiac action
potential and the interval between action potentials). Recent
experiments indicate that reducing the slope of the restitution
relation, either pharmacologically or by overexpression of selected
ionic currents, may prevent the induction and maintenance of ventricular
fibrillation. We are now in the process of evaluating various
methods of reducing dynamical heterogeneity, with the expectation
that such an approach might provide an effective means of preventing
sudden cardiac death, the leading cause of death in the US.