Effects of Serum Calcium Changes on the Cardiac Action Potential and the ECG in a Computational Model

Patients suffering from end stage of chronic kid ney disease (CKD) often undergo haemodialysis to normaliz the electrolyte concentrations. Moreover, cardiovascula disease (CVD) is the main cause of death in CKD patients To study the connection between CKD and CVD, we investi gated the effects of an electrolyte variation on cardiac signal (action potential and ECG) using a computational model. In first step, simulations with the Himeno et al. ventricular cel model were performed on cellular level with different extra cellular sodium ([Na+]o), calcium ([Ca2+]o) and potassium ([K+]o) concentrations as occurs in CKD patients. [Ca2+]o an [K+]o changes caused variations in different features describ ing the morphology of the AP. Changes due to a [Na+]o varia tion were not as prominent. Simulations with [Ca2+]o varia tions were also carried out on ventricular ECG level and 12-lead ECG was computed. Thus, a multiscale simulato from ion channel to ECG reproducing the calcium-dependen inactivation of ICaL was achieved. The results on cellular an ventricular level agree with results from literature. Moreover we suggest novel features representing electrolyte change that have not been described in literature. These results coul be helpful for further studies aiming at the estimation of ioni concentrations based on ECG recordings.