A simple electrical-mechanical model of the heart applied to the study of electrical-mechanical alternans

Recent evidence has shown that a subtle alternation in the surface ECG (electrical alternans) may be correlated with the susceptibility to ventricular fibrillation. In the present work, the author presents evidence that a mechanical alternation in the heartbeat (mechanical alternans) generally accompanies electrical alternans. A simple finite-element computer model which emulates both the electrical and the mechanical activity of the heart is presented. A pilot animal study is also reported. The computer model and the animal study both found that (1) there exists a regime of combined electrical-mechanical alternans during the transition from a normal rhythm towards a fibrillatory rhythm, (2) the detected degree of alternation is correlated with the relative instability of the rhythm, and (3) the electrical and mechanical alternans may result from a dispersion in local electrical properties leading to a spatial-temporal alternation in the electrical conduction process.