Figure 5 Rotors, wavebreak, and multiple circuit re-entry

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Figure 5 Rotors, wavebreak, and multiple circuit re-entry Figure 5 | Rotors, wavebreak, and multiple circuit re-entry. a | Instantaneous transmembrane potential (Vm) snapshot over a 2D grid of simulated human atrial tissue during re-entry induced by a single extrastimulus, which takes the form of a clockwise rotor (obtained with previously described simulation methods11,16,21,82). The leading edge of the wavefront is shown by the dashed white line. b | Wavebreak occurs when a propagating wavefront encounters a refractory obstacle, producing two counter-rotating waves. The points marked with an X in panels a and b represent phase singularity points. c | Top: Vm snapshots at 50-ms intervals of complex activity with the features of multiple circuit re-entry during atrial fibrillation induced in a 2D sheet of human atrial tissue with varying acetylcholine (ACh) concentration. The points marked with an X indicate phase singularity points. Bottom: Trajectories of phase singularities (black points) over the time of the simulation, superimposed on a map of ACh concentration. Phase singularities localize to regions of high ACh concentration, with regions of low ACh concentration acting as hypoexcitable barriers. Nattel, S. et al. (2017) Demystifying rotors and their place in clinical translation of atrial fibrillation mechanisms Nat. Rev. Cardiol. doi:10.1038/nrcardio.2017.37