Of circles and spirals: Bridging the gap between the leading circle and spiral wave concepts of cardiac reentry
Of circles and spirals: Bridging the gap between the leading circle and spiral wave concepts of cardiac reentry
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DOI：
10.1016/j.eupc.2005.05.011
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发表时间：
2005-09-01
期刊：
影响因子：
6.1
通讯作者：
Nattel, S
中科院分区：
文献类型：
--
作者：
Comtois, P;Kneller, J;Nattel, S
“引导环模型”是理解功能折返机制的首次详细尝试，并且仍然是心脏电生理学中广泛使用的概念。 “螺旋波”概念是最近作为现代理论分析的结果而发展起来的，并且是当前生物物理理论中考虑再入机制的基础。本文的目标是以生物物理学界和电生理学界都可以理解的方式呈现这些模型，其目的是帮助临床和实验电生理学家更好地理解螺旋波概念，并帮助生物物理学家理解为什么引导圆概念如此有吸引力并被电生理学家广泛使用。为此，提出了再入前导圈和螺旋波模型的主要性质。讨论了它们的基本假设和决定因素，并回顾了这两个概念对心律失常药理反应的预测。它们之间的主要区别在于对 Na+ 通道阻断的预测反应，其中螺旋波范式似乎更接近于临床和实验观察的结果。在模型的基本属性的背景下探讨了这种差异的基础。 (c) 2005 年欧洲心脏病学会。由爱思唯尔有限公司出版。保留所有权利。
The "leading circle model" was the first detailed attempt at understanding the mechanisms of functional reentry, and remains a widely-used notion in cardiac electrophysiology. The "spiral wave" concept was developed more recently as a result of modern theoretical analysis and is the basis for consideration of reentry mechanisms in present biophysical theory. The goal of this paper is to present these models in a way that is comprehensible to both the biophysical and electrophysiology communities, with the idea of helping clinical and experimental electrophysiologists to understand better the spiral wave concept and of helping biophysicists to understand why the leading circle concept is so attractive and widely used by electrophysiologists. To this end, the main properties of the leading circle and spiral wave models of reentry are presented. Their basic assumptions and determinants are discussed and the predictions of the two concepts with respect to pharmacological responses of arrhythmias are reviewed. A major difference between them ties in the predicted responses to Na+-channel blockade, for which the spiral wave paradigm appears more closely to correspond to the results of clinical and experimental observations. The basis of this difference is explored in the context of the fundamental properties of the models. (c) 2005 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved.