Influence of anisotropic conduction properties in the propagation of the cardiac action potential

Anisotropy, the property of being directionally dependent, is ubiquitous in nature. Propagation of the electrical impulse in cardiac tissue is anisotropic, a property that is determined by molecular, cellular, and histological determinants. The properties and spatial arrangement of connexin molecules, the cell size and geometry, and the fiber orientation and arrangement are examples of structural determinants of anisotropy. Anisotropy is not a static property but is subject to dynamic functional regulation, mediated by modulation of gap junctional conductance. Tissue repolarization is also anisotropic. The relevance of anisotropy extends beyond normal propagation and has important implications in pathological states, as a potential substrate for abnormal rhythms and reentry.