Genesis of complex fractionated atrial electrograms in zones of slow conduction: a computer model of microfibrosis.
Genesis of complex fractionated atrial electrograms in zones of slow conduction: a computer model of microfibrosis.
复制标题
复杂分数的起源是在缓慢传导区域中的心房电图：微纤维化的计算机模型。
DOI：
10.1016/j.hrthm.2009.02.026
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发表时间：
2009-06
期刊：
影响因子：
5.5
通讯作者：
Henriquez, Craig S.
中科院分区：
文献类型：
--
作者：
Jacquemet, Vincent;Henriquez, Craig S.
关键词：
房颤导管消融治疗的潜在靶点是复杂的分段性心房电信号。虽然纤维化与分离的心电图的存在有关，但通过检查心电图来表征基质是具有挑战性的。目的：确定微纤维化进展和传导减慢如何影响脑电形态。建立了一个代表单层心肌细胞的微结构计算机模型。慢传导是由(1)钠通道阻断，(2)细胞间偶联均匀减少，以及(3)微纤维化合并成一组分离横向偶联的胶原膜所致。这些胶原间隔的密度(0~30%)和长度(30~945μm)各不相同。在起搏节律期间，对一组不同尖端大小的电极计算了单极和双极的心电图。对单极心电图的时空滤波分析表明，增加胶原隔膜的密度和长度，可使传导速度降低75%，同时也增加了心电图的分支量(最多14个偏移量)和不对称性。相反，钠通道阻断或均匀减少的耦合引起的慢传导不会导致电信号的分离。当使用较大的电极时，电信号的幅度较小，分馏程度随底物的增加而增加。微尺度的障碍物会引起电信号波形的显著变化。传导速度、波幅和分流程度可以用来区分导致传导缓慢的基质的性质和纤维化的特征。
Complex fractionated atrial electrograms are used as potential targets for catheter ablation therapy of atrial fibrillation. Although fibrosis has been associated with the presence of fractionated electrograms, characterizing the substrate through the inspection of electrograms is challenging. To determine how progression of microfibrosis and slow conduction affect electrogram morphology. A microstructure computer model representing a monolayer of cardiac cells was developed. Slow conduction was induced by (1) sodium channel blockade, (2) uniform reduction in cell-to-cell coupling, and (3) microfibrosis incorporated as a set of collagenous septa disconnecting transverse coupling. The density (0 to 30%) and length (30 to 945 μm) of these collagenous septa were varied. Unipolar and bipolar electrograms were computed during paced rhythm for a set of electrodes with different tip sizes. The analysis of unipolar electrograms with realistic temporal and spatial filtering revealed that increasing the density and length of collagenous septa decreased conduction velocity by up to 75% and increased the amount of fractionation (up to 14 deflections) and asymmetry of the electrograms. In contrast, slow conduction induced by sodium channel blockade or uniformly-reduced coupling did not result in electrogram fractionation. When a larger electrode was used, electrogram amplitude was smaller and fractionation increased in a substrate-dependent way. Microscale obstacles cause significant changes to electrogram waveforms. Conduction velocity and electrogram amplitude and degree of fractionation can be used to discriminate the nature of the substrate and characteristics of fibrosis giving rise to slow conduction.
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影响因子：
37.8
作者：
ELLIS, WS;AUSLANDER, DM;LESH, MD
通讯作者：
LESH, MD
影响因子：
20.1
作者：
GESELOWITZ, DB;BARR, RC;MILLER, WT
通讯作者：
MILLER, WT
影响因子：
20.1
作者：
SPACH, MS;DOLBER, PC
通讯作者：
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影响因子：
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作者：
Nademanee, K;McKenzie, J;Ngarmukos, T
通讯作者：
Ngarmukos, T
DOI：
10.1152/ajpheart.01298.2007
发表时间：
2008-05-01
影响因子：
4.8
作者：
Jacquemet, Vincent;Henriquez, Craig S.
通讯作者：
Henriquez, Craig S.