Short-term cardiac memory and mother rotor fibrillation
Short-term cardiac memory and mother rotor fibrillation
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DOI：
10.1152/ajpheart.00944.2005
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发表时间：
2007-01-01
影响因子：
4.8
通讯作者：
Weiss, James N.
中科院分区：
文献类型：
--
作者：
Baher, Ali;Qu, Zhilin;Weiss, James N.
短期心脏记忆是指起搏历史对动作电位时程（APD）的影响。尽管人们对多次心跳中发生的短期记忆（也称为APD调节）的离子机制知之甚少，但它们可能对折返和纤颤有重要影响。为了探索这个问题，我们将一个通用的记忆电流的相位I罗和鲁迪动作电位模型，缺乏短期记忆。该电流的特性被匹配以定量地模拟人心室单相动作电位调节。我们表明，从理论上讲，短期记忆可以解决的悖论，如何在异质组织的生理起搏的母亲转子纤维性颤动。在模拟的异质性二维组织和三维心室含有内向整流K+电流梯度，短期记忆可以自发地转换多小波纤颤母转子纤颤或两种纤颤类型的混合物。这是由于转子的逐渐加速和稳定，因为记忆的积累缩短了APD，并且在整个组织中APD恢复斜率不均匀地变平。
Short-term cardiac memory refers to the effects of pacing history on action potential duration (APD). Although the ionic mechanisms for short-term memory occurring over many heartbeats (also called APD accommodation) are poorly understood, they may have important effects on reentry and fibrillation. To explore this issue, we incorporated a generic memory current into the Phase I Luo and Rudy action potential model, which lacks short-term memory. The properties of this current were matched to simulate quantitatively human ventricular monophasic action potential accommodation. We show that, theoretically, short-term memory can resolve the paradox of how mother rotor fibrillation is initiated in heterogeneous tissue by physiological pacing. In simulated heterogeneous two-dimensional tissue and three-dimensional ventricles containing an inward rectifier K+ current gradient, short-term memory could spontaneously convert multiple wavelet fibrillation to mother rotor fibrillation or to a mixture of both fibrillation types. This was due to progressive acceleration and stabilization of rotors as accumulation of memory shortened APD and flattened APD restitution slope nonuniformly throughout the tissue.