Circus movement atrial flutter in the canine sterile pericarditis model. Activation patterns during initiation, termination, and sustained reentry in vivo.
Circus movement atrial flutter in the canine sterile pericarditis model. Activation patterns during initiation, termination, and sustained reentry in vivo.
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犬无菌性心包炎模型中的马戏团运动心房扑动。
DOI：
10.1161/01.res.67.1.35
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发表时间：
1990
影响因子：
20.1
通讯作者：
el-Sherif,N
中科院分区：
文献类型：
--
作者：
Schoels,W;Gough,WB;Restivo,M;el-Sherif,N
尚未显示在没有解剖学上预先确定的路径的情况下合胞体中单环折返的机制。我们使用尼龙基质中带有 111 个双极电极的“夹克电极”，在患有无菌性心包炎的狗的心房扑动期间对心房心外膜表面进行原位绘制。在 21 次折返性心房扑动中，只有 4 次出现双环（“8 字形”）折返，而 17 次出现单环折返。在单环折返启动期间，功能阻滞弧延伸至房室 (AV) 环。这迫使激活以围绕电弧自由端的单波形式进行，然后突破靠近 AV 环的电弧。当弧连接心房血管时，激活继续围绕靠近 AV 环的弧（八次）或围绕功能和解剖组合障碍（九次）进行一圈。慢传导区始终以阻滞弧和 AV 环或解剖障碍和 AV 环为边界。当该区域传导失败并且电弧重新加入 AV 环时，就会发生自发终止。沿块弧的高密度记录（2毫米）显示由等电间隔分隔的双电势，解释为由于弧另一侧的激活而导致的局部激活和电紧张。组织学上，弥漫性炎症反应涉及50-80%的心房壁。心肌束的过渡层保留了交叉条纹，但被水肿和炎症细胞隔开，被包围在碎片心肌细胞的心外膜层和大致完整的心肌的心内膜层之间。功能性传导阻滞或传导减慢部位没有明显特征。总之，单环折返是该模型心房扑动期间的常见模式。其诱导取决于 AV 环、功能性阻滞弧和慢传导区的相互作用。下腔静脉的位置使右下心房易于发生这种类型的折返。
The mechanisms of single-loop reentry in a syncytium without anatomically predetermined pathways have not been shown. Using a "jacket electrode" with 111 bipolar electrodes in a nylon matrix, we mapped in situ the atrial epicardial surface during atrial flutter in dogs with sterile pericarditis. Of 21 episodes of reentrant atrial flutter, only four showed double-loop ("figure-eight") reentry, whereas in 17 episodes a single loop was present. During initiation of single-loop reentry, an arc of functional block extended to the atrioventricular (AV) ring. This forced activation to proceed as a single wave around the free end of the arc, before breaking through the arc close to the AV ring. Activation continued as one loop around an arc close to the AV ring (in eight episodes) or around a combined functional and anatomic obstacle (in nine episodes) when the arc joined an atrial vessel. A zone of slow conduction was consistently bordered by the arc of block and the AV ring or by the anatomic obstacle and the AV ring. Spontaneous termination occurred when conduction failed in this area and the arc rejoined the AV ring. High-density recordings (2 mm) along the arc of block showed double potentials separated by an isoelectric interval, interpreted as local activation and electrotonus due to activation on the opposite side of the arc. Histologically, a diffuse inflammatory reaction involved 50-80% of the atrial wall. A transitional layer of myocardial bundles with preserved cross striation, but separated by edema and inflammatory cells, was enclosed between an epicardial layer of fragmented myocytes and an endocardial layer of grossly intact myocardium. There were no distinctive features at sites of functional conduction block or slowed conduction. In conclusion, single-loop reentry is the common pattern during atrial flutter in this model. Its induction depends on an interaction of the AV ring, a functional arc of block, and a zone of slow conduction. The location of the inferior vena cava predisposes the lower right atrium to this type of reentry.
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演示常见类型心房扑动的大折返和手术治疗的可行性。
DOI：
10.1016/0002-9149(86)90840-4
发表时间：
1986
期刊：
The American journal of cardiology
影响因子：
--
作者：
G. Klein;G. Guiraudon;A. Sharma;S. Milstein
通讯作者：
S. Milstein
影响因子：
20.1
作者：
W. Hayden;E. Hurley;D. A. Rytand
通讯作者：
D. A. Rytand
DOI：
10.1620/tjem.60.197
发表时间：
1954
期刊：
The Tohoku journal of experimental medicine
影响因子：
--
作者：
Eiichi Kimura;K. Kato;Satoru Murao;Hidero Ajisaka;Shintaro Koyama;Z. Omiya
通讯作者：
Z. Omiya
影响因子：
20.1
作者：
A. Maurits;Allessie;M. FélixI;Bonke;G. FRANCIENJ.;Schopman
通讯作者：
Schopman
心房额外刺激和快速起搏对心房扑动周期影响的临床和实验研究。
DOI：
10.1016/0002-9149(81)90139-9
发表时间：
1981
期刊：
The American journal of cardiology
影响因子：
--
作者：
H. Inoue;H. Matsuo;K. Takayanagi;S. Murao
通讯作者：
S. Murao