An S1 gradient of refractoriness is not essential for reentry induction by an S2 stimulus.

Abstract

This communication reports a numerical simulation of reentry induction by successive stimulation (S1-S2) that does not require an S1 gradient of refractoriness. The S1 action potential is uniform in space, so before the S2 stimulus there is no refractory gradient. Nevertheless, a unipolar S2 stimulus initiates quatrefoil reentry. The result supports the growing realization that virtual electrodes, hyperpolarization, de-excitation, and break excitation may be important during reentry induction.