AUTHOR=Mendonca Costa Caroline , Plank Gernot , Rinaldi Christopher A. , Niederer Steven A. , Bishop Martin J. 

TITLE=Modeling the Electrophysiological Properties of the Infarct Border Zone

JOURNAL=Frontiers in Physiology

VOLUME=Volume 9 - 2018

YEAR=2018

URL=https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2018.00356

DOI=10.3389/fphys.2018.00356

ISSN=1664-042X

ABSTRACT=Ventricular arrhythmias in patients with myocardial infarction are thought to be associated
with structural and electrophysiological remodelling within the infarct border zone. Personalised
computational models have been used to investigate the potential role of the infarct border zone in
arrhythmogenesis, which still remains incompletely understood. Most recent models have relied
on experimental data to assign border zone properties. However, experimental measurements
vary significantly resulting in different computational representations of this region. Here, we
review experimental data available in the literature to determine the most prominent properties
of the infarct border zone. Computational models are then used to investigate the effect of
different representations of the border zone on activation and repolarisation properties, which
may be associated with ventricular arrhythmias. Experimental data obtained from several animal
species and patients with infarct show that border zone properties vary significantly depending
on disease’s stage, with the early disease stage dominated by ionic remodelling and the chronic
stage by structural remodelling. In addition, our simulations show that ionic remodelling in the
border zone leads to large repolarisation gradients in the vicinity of the scar, which may have
a significant impact on arrhythmia simulations, while structural remodelling plays a secondary
role. We conclude that it is imperative to faithfully represent the properties of regions of infarction
within computational models specific to the disease stage under investigation in order to conduct
in-silico mechanistic investigations.