Purkinje activation precedes myocardial activation following defibrillation after long-duration ventricular fibrillation.
Purkinje activation precedes myocardial activation following defibrillation after long-duration ventricular fibrillation.
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DOI：
10.1016/j.hrthm.2009.11.025
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发表时间：
2010-03
期刊：
影响因子：
5.5
通讯作者：
Ideker, Raymond E.
中科院分区：
文献类型：
--
作者：
Dosdall, Derek J.;Osorio, Jose;Robichaux, Robert P.;Huang, Jian;Li, Li;Ideker, Raymond E.
虽然在室壁内折返负责维持短时间的室颤(SDVF，VF持续时间和1分钟)，而浦肯野纤维(PF)在维持长时间的室颤(LDVF，VF持续时间和1分钟)中是重要的。我们推测，SDVF和LDVF的除颤机制也可能不同。在8只Beagle犬的左心室内放置多电极篮形导管。体外除颤电击在SDVF(S 20例)和LDVF(S 150例)之后采用升压程序进行。最早的Vm和Pf激活是在未能终止VF的最高能量休克和成功的休克之后发现的。SDVF除颤成功时间为36±12 S，LDVF除颤时间为181±14 S。失败性休克患者休克后至最早激活的时间(138.7±24.1ms)明显长于深低温(75.6ms±8.7ms)。SDVF后最早的休克后激活通常开始于Vm(16次发作中的14次)，而它总是在LDVF后的PF中开始(16次中的16次)。在PF引导的周期中，窦性节律中最早活动的部位与最早的休克后激活部位相关，而在Vm引导的周期中，与之无关。记录到的最早的休克后激活是在LDVF之后的浦肯野系统，而不是SDVF。这种差异增加了SDVF和LDVF的最佳除颤策略不同的可能性。
While reentry within the ventricular myocardium (VM) is responsible for the maintenance of short duration ventricular fibrillation (SDVF, VF duration < 1 min), Purkinje fibers (PFs) are important in the maintenance of long duration ventricular fibrillation (LDVF, VF duration > 1 min). We hypothesized that the mechanisms of defibrillation may also be different for SDVF and LDVF. A multielectrode basket catheter was deployed in the left ventricle of 8 beagles. External defibrillation shocks were delivered with a ramp-up protocol following SDVF (20 s) and LDVF (150 s). Earliest VM and PF activations were identified following the highest energy shock that failed to terminate VF and the successful shock. Defibrillation was successful after 36±12 s and 181±14 s for SDVF and LDVF, respectively. The time after shock delivery until earliest activation was detected for failed shocks and was significantly longer following LDVF (138.7±24.1 ms) than SDVF (75.6±8.7 ms). Earliest postshock activation following SDVF typically initiated in the VM (14 of 16 episodes) while it always initiated in the PF (16 of 16 episodes) following LDVF. Sites of earliest activity during sinus rhythm correlated with sites of earliest postshock activation for PF-led cycles but not VM-led cycles. Earliest recorded postshock activation is in the Purkinje system following LDVF but not SDVF. This difference raises the possibility that the optimal defibrillation strategy is different for SDVF and LDVF.
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影响因子：
2.8
作者：
WORLEY, SJ;SWAIN, JL;IDEKER, RE
通讯作者：
IDEKER, RE
DOI：
10.1111/j.1540-8167.2007.00963.x
发表时间：
2007-12-01
影响因子：
2.7
作者：
Allison, J. Scott;Qin, Hao;Ideker, Raymond E.
通讯作者：
Ideker, Raymond E.
影响因子：
15.9
作者：
CHEN, PS;SHIBATA, N;IDEKER, RE
通讯作者：
IDEKER, RE
影响因子：
5.5
作者：
Dosdall, Derek J.;Cheng, Kang-An;Ideker, Raymond E.
通讯作者：
Ideker, Raymond E.
影响因子：
20.1
作者：
FRAZIER, DW;KRASSOWSKA, W;IDEKER, RE
通讯作者：
IDEKER, RE