Atrial fibrillation may be a vascular disease: The role of the pulmonary vein
Atrial fibrillation may be a vascular disease: The role of the pulmonary vein
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DOI：
10.1016/j.mehy.2006.07.048
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发表时间：
2007-01-01
影响因子：
4.7
通讯作者：
Yan Bo Li
中科院分区：
文献类型：
--
作者：
Cong Xin Huang;Cheng Lin Hu;Yan Bo Li
近年来，人们对肺静脉（PVs）在心房中的作用进行了大量的实验和临床研究。纤维性颤动（AF）。肺静脉含有心肌细胞，由于增强的自律性、触发活动的诱导和微折返回路的产生，这些心肌细胞具有容易诱导的促心律失常活性。增强的自律性，诱导触发活动，无论是单独或与折返机制相结合，详细的标测研究表明，肺静脉内的折返最有可能是其致心律失常的原因。毫无疑问，肺静脉是阵发性房颤患者最重要的致心律失常活动来源。AF时，病理情况的存在对于增强PV致炎活性是重要的。冠状窦或上级腔静脉也可能是房颤时快速重复电活动的来源，因此，房颤应被视为一种血管疾病。此外，在起源于肺静脉的阵发性房颤患者中，心律失常可能共存，包括房性早搏、心动过速、扑动和纤颤的发作。这类心律失常应命名为肺静脉房性心律失常。心律不齐这些新的观点将有助于了解AF的机制，诊断和治疗方法。（c）2006爱思唯尔有限公司保留所有权利。
Recent years have seen an enormous amount of experimental and clinical research into role of the pulmonary veins (PVs) in atrial. fibrillation (AF). The PVs contain cardiomyocytes with easily inducible arrhythmogenic activity due to the enhanced automaticity, induction of triggered activity, and genesis of microreentrant circuits. The enhanced automaticity, induced triggered activity, either alone or in combination with the reentrant mechanisms, may play a rote in the initiation of PVs AF. Detailed mapping studies suggest that reentry within the PVs is most likely responsible for their arrhythmogenicity.There is no doubt that the PVs represent the most important source of arrhythmogenic activity in patients with paroxysmal AF. In AF patients with risk factors for development of AF, the presence of the pathological situation is important in enhancing the PV arrhythmogenic activity. Coronary sinus or superior vena cava may also be a source of rapid repetitive electrical activity during AF. Thus, AF should be considered a kind of vascular disease. Moreover, in patients with paroxysmal AF originating from the PVs, a wide spectrum of atrial. arrhythmias may coexist, including paroxysms of atrial premature, tachycardia, flutter and fibrillation. This kind of arrhythmias should be named as PV atrial. arrhythmias. These new views will help understand the mechanism, diagnosis and treatment method for AF. (c) 2006 Elsevier Ltd. All rights reserved.