Spatiotemporal periodicity during atrial fibrillation in the isolated sheep heart
Spatiotemporal periodicity during atrial fibrillation in the isolated sheep heart
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DOI：
10.1161/01.cir.98.12.1236
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发表时间：
1998-09-22
期刊：
影响因子：
37.8
通讯作者：
Jalife, J
中科院分区：
文献类型：
--
作者：
Skanes, AC;Mandapati, R;Jalife, J
背景--心房颤动(房颤)期间不规则电活动背后的激活模式传统上被描述为无序或随机的。最近的研究，主要基于统计学方法，已经提供了房颤在空间上有组织的证据。本研究的目的是证实房颤过程中时间和空间周期性的存在。方法和结果--我们使用高分辨率视频成像、心电记录和频谱分析相结合的方法来识别在6个朗宁多夫灌流的羊心20次房颤发作过程中具有时间周期性和相似空间传播模式的序列波阵面，房颤频谱分析显示所有病例的房颤都有多个窄带峰，只有一个主峰(平均9.4+/-2.6 Hz；周期长度为112+/-26ms)，在20个右心房(RA)的光学记录中有12个发现了时空周期性的证据，在所有(N 19)个左心房(LA)的记录中都发现了时空周期性的证据。时空周期波的周期长度与其光学伪心电信号的主频相关(LA：R-2=0.99，斜率=0.94[95%CI，0.88~0.99]；RA：R-2=0.97，斜率=0.92[95%CI，0.80~1.03])。左房假性心电信号的优势频率与整体双极房电相关(R2=0.76，斜率=0.75[95%CI，0.52~0.99])。在特定的例子中，周期性活动的来源被认为是心外膜层中的转子，或者是最有可能代表跨壁梳状肌折返的周期性突破。然而，在大多数情况下，可以看到周期波从视野边缘进入标测区域。结论：解剖或功能决定的回路中的折返构成了房颤时时空周期活动的基础。在这个房颤实验模型中，LA中源的周期长度决定了频谱中的主峰。
Background-The activation patterns that underlie the irregular electrical activity during atrial fibrillation (AF) have traditionally been described as disorganized or random. Recent studies, based predominantly on statistical methods, have provided evidence that AF is spatially organized. The objective of this study was to demonstrate the presence of spatial and temporal periodicity during AF.Methods and Results-We used a combination of high-resolution video imaging, ECG recordings, and spectral analysis to identify sequential wave fronts with temporal periodicity and similar spatial patterns of propagation during 20 episodes of AF in 6 Langendorff-perfused sheep hearts, Spectral analysis of AF demonstrated multiple narrow-band peaks with a single dominant peak in all cases (mean, 9.4 +/- 2.6 Hz; cycle length, 112 +/- 26 ms), Evidence of spatiotemporal periodicity was found in 12 of 20 optical recordings of the right atrium (RA) and in all (n 19) recordings of the left atrium (LA). The cycle length of spatiotemporal periodic waves correlated with the dominant frequency of their respective optical pseudo-ECGs (LA: R-2=0.99, slope=0.94 [95% CI, 0.88 to 0.99]; RA: R-2=0.97, slope=0.92 [95% CI, 0.80 to 1.03]). The dominant frequency of the LA pseudo-EGG alone correlated with the global bipolar atrial EG (R-2=0.76, slope=0.75 [95% CI, 0.52 to 0.99]). In specific examples, sources of periodic activity were seen as rotors in the epicardial sheet or as periodic breakthroughs that most likely represented transmural pectinate muscle reentry. However, in the majority of cases, periodic waves were seen to enter the mapping area from the edge of the field of view.Conclusions-Reentry in anatomically or functionally determined circuits forms the basis of spatiotemporal periodic activity during AF. The cycle length of sources in the LA determines the dominant peak in the frequency spectra in this experimental model of AF.