Incidence, evolution, and spatial distribution of functional reentry during ventricular fibrillation in pigs.
Incidence, evolution, and spatial distribution of functional reentry during ventricular fibrillation in pigs.
复制标题
猪心室颤动期间功能折返的发生率、演变和空间分布。
DOI：
10.1161/01.res.84.8.945
复制
发表时间：
1999
影响因子：
20.1
通讯作者：
Ideker,RE
中科院分区：
文献类型：
--
作者：
Rogers,JM;Huang,J;Smith,WM;Ideker,RE
-功能性再入被假设为心室颤动（VF）的潜在机制；然而，在完全发育的VF期间，它对激活模式的贡献尚不清楚。我们应用了新的定量模式分析技术，对7只开胸、无支架的猪室性心外膜上的21×24单极电极阵列（间距2毫米）获得的数据进行制图。分析电磁感应后1、10、20、30、40秒开始的4秒长的数据epoch。可重入电路被自动识别和量化。我们发现2.3%的激活途径可以明确地归类为可重入性。从尺度分析来看，另外28%的路径也可能是可重入的。再入周期较短，每次循环1.5±1.5（平均±SD）个完整周期。随着VF的进展，可重入通路的比例、每个回路的循环次数、循环持续时间以及核心的面积和周长均显著增加。岩心漂移速度明显降低。心外膜纤维取向不能很好地预测芯的方向和漂移方向（线性回归r2分别为0.108和0.138）。可重入回路聚集在心外膜区域。我们得出以下结论：(1)心外膜再入相对罕见且短暂，表明持续再入是跨壁的，或者控制持续再入的机制对VF动力学相对不重要。(2)随着VF的进展，可重入回路变得更普遍、更大、更持久，这可以解释最近观察到的VF组织在VF的第一分钟增加。(3)诱导和维持再入所需的条件分布不均匀。
—Functional reentry has been hypothesized to be an underlying mechanism of ventricular fibrillation (VF); however, its contribution to activation patterns during fully developed VF is unclear. We applied new quantitative pattern analysis techniques to mapping data acquired from a 21×24 unipolar electrode array (2-mm spacing) located on the ventricular epicardium of 7 open-chest, unsupported pigs. Data epochs 4 seconds long beginning 1, 10, 20, 30, and 40 seconds after electrical induction were analyzed. Reentrant circuits were automatically identified and quantified. We found that 2.3% of activation pathways could unambiguously be classified as reentrant. From scaling analysis, an additional 28% of the pathways may also have been reentrant. Reentry was short-lived with 1.5±1.5 (mean±SD) complete cycles per circuit. The fraction of reentrant pathways, number of cycles per circuit, cycle duration, and area and perimeter of the cores all increased significantly as VF progressed. Core drift speed decreased significantly. Neither the orientation of the cores nor the direction of drift was well predicted by the epicardial fiber orientation (r2=0.108 and 0.138, respectively, by linear regression). Reentrant circuits were clustered in regions of the epicardium. We conclude the following: (1) Epicardial reentry is relatively uncommon and short-lived during VF, suggesting either that sustained reentry is transmural or that mechanisms governing sustained reentry are relatively unimportant to the dynamics of VF. (2) Reentrant circuits become more common, larger, and longer-lived as VF progresses, which may explain a recently observed increase in VF organization during the first minute of VF. (3) The conditions necessary to induce and sustain reentry are distributed nonuniformly.