CANINE VENTRICULAR ARRHYTHMIAS IN THE LATE MYOCARDIAL-INFARCTION PERIOD .8. EPICARDIAL MAPPING OF REENTRANT CIRCUITS
CANINE VENTRICULAR ARRHYTHMIAS IN THE LATE MYOCARDIAL-INFARCTION PERIOD .8. EPICARDIAL MAPPING OF REENTRANT CIRCUITS
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DOI：
10.1161/01.res.49.1.255
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发表时间：
1981-01-01
影响因子：
20.1
通讯作者：
EVANS, K
中科院分区：
文献类型：
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作者：
ELSHERIF, N;SMITH, RA;EVANS, K
结扎犬左前降支后3-5天，用48个双极电极同步记录诱发室性心律失常时的心外膜等时线图。有强有力的证据表明，在所分析的21%的异位搏动中，折返回路（RC）主要在心外膜表面上可辨别。心外膜记录在分析其他搏动的心律失常方面价值有限。折返回路由一个弧形传导阻滞组成，围绕该传导阻滞，激活前沿以缓慢但不均匀的速度以环形方式前进，而心室的其余部分则通过径向扩散激活。RC周围形成的传导阻滞弧通常是功能性的，因为心肌的相同区域在相对长的心动周期长度下是可兴奋的。传导阻滞弧的长度（决定折返环的长度）和传导延迟的程度是折返发生的关键因素。与未能诱导折返的早搏相比，引发折返的早搏导致更长的传导阻滞弧和更慢的传导。
Simultaneous recordings from 48 bipolar electrodes were made to obtain epicardial isochronal maps during induced ventricular arrhythmias in dogs 3-5 days after ligation of the left anterior descending artery. There was strong evidence of a reentrant circuit (RC) that was discernible largely on the epicardial surface in 21% of ectopic beats that were analyzed. Epicardial recordings were of limited value in analyzing the arrhythmia in other beats. The reentrant circuit consisted of an arc of conduction block around which the activation front advanced in a circular fashion at slow but uneven speeds while the rest of the ventricle was activated by radial spread. The arc of conduction block around which the RC was formed was usually functional in nature, since the same area of myocardium was excitable at relatively long cardiac cycle lengths. Both the length of the arc of conduction block which defines the length of the reentrant circuit and the degree of conduction delay were crucial factors for the occurrence of reentry. A premature beat that initiated reentry resulted in a longer arc of conduction block and slower conduction compared to one that failed to induce reentry.