EP Europace, Journal Year: 2024, Volume and Issue: 26(11)

Published: Nov. 1, 2024

The co-ordinated electrical activity of ∼2 billion cardiac cells ensures stability the heartbeat. Indeed, remarkably low incidence (<1%) ventricular arrhythmias in healthy heart is only possible when event across this syncytium closely controlled. In contrast, diseased myocardium associated with increased electrophysiological heterogeneity, unstable rhythm, and lethal arrhythmias. But what link between cellular tissue level heterogeneity? Recent research has shown existence considerable heterogeneity even heart, suggesting that cell-to-cell variability (e.g. action potential duration) mechanical performance twitch amplitude) a normal property. This observation been previously unappreciated because aggregated function form QT-interval output varies <1% on beat-to-beat basis. article describes underlying tolerated-and perhaps needed-by different regions for indicates why not apparent at chamber organ level. Thus, contrast to current dominant view, postulates potentially endows various functional benefits. new view how component parts come together also suggests novel mechanisms pathologies, namely dysfunction may emerge from changes extent and/or nature heterogeneity. Once understood, restoring forms could be approach treatment.

Language: Английский