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Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and it is a significant risk factor for stroke and other morbidities if left untreated. The most dangerous and complex arrhythmias are the result of the phenomenon known as reentry. In experimental studies, the vena cava has been associated with ectopic activity that promotes the generation of reentries. The changes caused by electrical remodeling in an action potential model (AP) of atrial myocyte, coupled with an anatomically realistic three-dimensional model of human atria with orientation fibers were incorporated in this work. When apply an ectopic focus at the nearby of the ostium of the inferior vena cava a relationship between this activity and the generation of reentries in the pectinate muscles is found. A functional reentry that is repeated in the time favored by the pectinate muscles anatomy, the anisotropic properties and the non-uniform distribution in the three-dimensional tissue was obtained. The existence of a preferential conduction pathway facilitates the initiation of reentries affecting the conduction scheme and therefore the capacity of induction and development of arrhythmias is found.

Implication of the inferior vena cava in the generation of reentry in the pectinate muscles