Work

Gerrymandering in the heart: How tissue heterogeneities promote premature ventricular contractions

Year: 2026

Type: article

Abstract: waves at the subcellular level promote transient inward currents that lead to delayed afterdepolarizations at the cellular level. In uniform, healthy tissue, such events are often benign because the surrounding healthy cells act as an electrical sink, suppressing the abnormal signals from a few pathological source cells. This phenomenon is known as "source-sink mismatch." In this study, using computational modeling, we show how structural and functional tissue heterogeneities can overcome this protective mechanism. Regions of weak electrical coupling or specific cellular arrangements can electrically isolate small clusters of pathological cells. Within such isolated regions, the number of abnormal cells can more easily reach the "critical mass" required to overcome the source-sink mismatch and initiate a PVC. This principle, where the spatial arrangement of a minority group enables it to determine a local outcome of the whole group, is analogous to the political concept of gerrymandering. Our findings provide a novel mechanistic framework for understanding arrhythmia initiation and highlight the critical role of tissue heterogeneity.

Source: Biophysical Journal

DOI: 10.1016/j.bpj.2026.03.057

Authors: Daisuke Sato, Donald M. Bers

Institution: University of California, Davis

Language: English

Topic: Cardiac electrophysiology and arrhythmias

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,000