Alternans and 2:1 rhythms in an ionic model of heart cells

ECG alternans is commonly held to be an indicator of electrical instability of the heart, but the development of alternans has not yet been fully understood theoretically. We investigate the onset of alternans and 2:1 rhythms for stimulation at increasing frequencies in the Beeler–Reuter model, a simple ionic model of cardiac tissue. We find hysteresis and bistability at the onset of alternans; well-timed stimuli can switch between the two limit cycles. We determine quantitatively the effect of blocking specific ionic currents. Moreover, we find that calcium buffers generally promote alternans.