Table 1.
Arrhythmogenic mechanisms in the GI and cardiovascular systems can be divided into non-reentrant and reentrant activity.
| Classification | Mechanism | Sub-types | Clinical relevance | References |
|---|---|---|---|---|
| Non-reentrant | Enhanced pacemaker activity | – | GI: Gastroparesis, intestinal infection, inflammation and mitochondrial dysfunction | Der et al., 2000; O'Grady et al., 2011, 2012; Scheffer and Smout, 2011; Wu et al., 2013 |
| – | Cardiac: increased sympathetic tone, hypovolaemia, ischaemia, electrolyte disturbances | Jalife et al., 2009; Tse, 2015 | ||
| Triggered activity | Second potentials (GI) | Tachygastria | Daniel and Chapman, 1963; Suzuki and Hirst, 1999; Lammers and Slack, 2001; Qian et al., 2003; Lammers et al., 2008 | |
| Early afterdepolarizations (cardiac) | Long QT syndromes, heart failure | Weiss et al., 2010; Maruyama et al., 2011 | ||
| Delayed afterdepolarizations (cardiac) | Ca2+ overload Catecholaminergic polymorphic ventricular tachycardia (CPVT), heart failure | Priori et al., 2001; Nam et al., 2005 | ||
| Reentrant | Obstacle | Anatomical (GI and cardiac) | GI: circumferential reentry | Sinha et al., 2002; Angeli et al., 2013 |
| Cardiac: AV nodal reentrant tachycardia, AV reentrant tachycardia and pre-excitation syndromes, post-myocardial infarction, fibrosis in cardiomyopathies, myocarditis, cardio-metabolic disorders | Wong et al., 2013; Vassiliou et al., 2014; Baksi et al., 2015; Tse et al., 2015a,b; Tse et al., 2016a | |||
| Functional (GI and cardiac) | GI: double-loop | Gullikson et al., 1980; Stoddard et al., 1981; Kim et al., 1987; Lammers et al., 2012; Angeli et al., 2013 | ||
| Cardiac: spiral and scroll wave, figure-of-eight, torsade de pointes | Allessie et al., 1973, 1975, 1976, 1977, 1989; Smeets et al., 1986; Rensma et al., 1988 | |||
| No obstacle | Reflection (cardiac) | Ischaemia | Antzelevitch et al., 1980; Antzelevitch and Moe, 1981; Rozanski et al., 1984; Lukas and Antzelevitch, 1989; Auerbach et al., 2011; Tung, 2011 | |
| Phase 2 (cardiac) | Ischaemia, Ca2+ overload, Brugada syndrome | Kuo et al., 1983; Di Diego and Antzelevitch, 1993; Lukas and Antzelevitch, 1996; Shimizu et al., 2005 |