The virtual sinoatrial node: What did computational models tell us about cardiac pacemaking?

Since its discovery, the sinoatrial node (SAN) has represented a fascinating and complex matter of research. Despite over a century of discoveries, a full comprehension of pacemaking has still to be achieved. Experiments often produced conflicting evidence that was used either in support or against alternative theories, originating intense debates. In this context, mathematical descriptions of the phenomena underlying the heartbeat have grown in importance in the last decades since they helped in gaining insights where experimental evaluation could not reach. This review presents the most updated SAN computational models and discusses their contribution to our understanding of cardiac pacemaking. Electrophysiological, structural and pathological aspects - as well as the autonomic control over the SAN - are taken into consideration to reach a holistic view of SAN activity.

Coupling and heterogeneity modulate pacemaking capability in healthy and diseased two-dimensional sinoatrial node tissue models.

Both experimental and modeling studies have attempted to determine mechanisms by which a small anatomical region, such as the sinoatrial node (SAN), can robustly drive electrical activity in the human heart. However, despite many advances from prior research, important questions remain unanswered. This study aimed to investigate, through mathematical modeling, the roles of intercellular coupling and cellular heterogeneity in synchronization and pacemaking within the healthy and diseased SAN. In a multicellular computational model of a monolayer of either human or rabbit SAN cells, simulations revealed that heterogenous cells synchronize their discharge frequency into a unique beating rhythm across a wide range of heterogeneity and intercellular coupling values. However, an unanticipated behavior appeared under pathological conditions where perturbation of ionic currents led to reduced excitability. Under these conditions, an intermediate range of intercellular coupling (900-4000 MΩ) was beneficial to SAN automaticity, enabling a very small portion of tissue (3.4%) to drive propagation, with propagation failure occurring at both lower and higher resistances. This protective effect of intercellular coupling and heterogeneity, seen in both human and rabbit tissues, highlights the remarkable resilience of the SAN. Overall, the model presented in this work allowed insight into how spontaneous beating of the SAN tissue may be preserved in the face of perturbations that can cause individual cells to lose automaticity. The simulations suggest that certain degrees of gap junctional coupling protect the SAN from ionic perturbations that can be caused by drugs or mutations.

Technical Proposal for Monitoring Thermal and Mechanical Stresses of a Runway Pavement.

Airport pavements should ensure regular and safe movements during their service life; the management body has to monitor the functional and structural characteristics, and schedule maintenance work, balancing the often conflicting goals of safety, economic and technical issues. This paper presents a remote monitoring system to evaluate the structural performance of a runway composed of concrete thresholds and a flexible central runway. Thermometers, strain gauges, and pressure cells will be embedded at different depths to continuously monitor the pavement's response to traffic and environmental loads. An innovative system allows data acquisition and processing with specific calculation models, in order to inform the infrastructure manager, in real time, about the actual conditions of the pavement. In this way, the authors aim to develop a system that provides useful information for the correct implementation of an airport pavement management system (APMS) based on real-life data. Indeed, it permits comprehensive monitoring functions to be performed, based on the embedded sensing network.