
This study explores how spatially discordant alternans (SDA) arise in bidirectional ventricular tachycardia (BVT) due to periodic pacing site alternation. Using mathematical models, researchers demonstrate that alternating pacing from two sites causes varying timing of electrical stimulation across cardiac tissue, leading to abnormal action potential durations. The orientation of nodal lines perpendicular to wavefronts enhances arrhythmogenicity. This finding helps predict SDA patterns based on tissue geometry and pacing site distribution in BVT.
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