Regional cooling facilitates termination of spiral-wave reentry through unpinning of rotors in rabbit hearts.
Regional cooling facilitates termination of spiral-wave reentry through unpinning of rotors in rabbit hearts.
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DOI：
10.1016/j.hrthm.2011.08.013
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发表时间：
2012-01
期刊：
影响因子：
5.5
通讯作者：
Kodama, Itsuo
中科院分区：
文献类型：
--
作者：
Yamazaki, Masatoshi;Honjo, Haruo;Ashihara, Takashi;Harada, Masahide;Sakuma, Ichiro;Nakazawa, Kazuo;Trayanova, Natalia;Horie, Minoru;Kalifa, Jerome;Jalife, Jose;Kamiya, Kaichiro;Kodama, Itsuo
关键词：
研究表明，适度的心肌组织整体降温可以破坏二维(2-D)再入的稳定性并促进其终止。本研究试图验证这样的假设，即局部降温破坏了转子的稳定性，并有助于终止自发性和直流电击诱导的心外膜下折返性心内膜下心脏。在兰氏灌流的兔心外膜下2-D心肌上记录到荧光动作电位信号。局部降温(5.9℃±1.3℃)采用透明降温装置(直径10 mm)对左心室前壁进行降温。持续刺激(2.5 Hz)时局部降温使降温区动作电位时程延长(36%±9%)，传导速度略有减慢(4%±4%)。局部降温引起的室性心动过速(VTS)较未降温时提前终止(对照组)：持续30秒的室性心动过速从39例中的17例减少到61例中的1例。在持续室速期间(>；120秒)进行局部降温时，33例持续性室速中有16例(48%)在12.5±5.1秒内自行终止。VT终止是转子失稳的结果，其特征是脱钉，向冷却区外围漂移，随后与边界碰撞。持续室速复律所需的直流电击强度在局部降温后显著降低(22.8±4.1V，n=16，vs40.5±17.6V，n=21)。直流冲击终止再入大气层的主要方式是在没有冷却的情况下重置相位，而在有冷却的情况下是解钉的。区域冷却有助于通过解锁转子来终止2-D再入。
Moderate global cooling of myocardial tissue was shown to destabilize 2-dimensional (2-D) reentry and facilitate its termination. This study sought to test the hypothesis that regional cooling destabilizes rotors and facilitates termination of spontaneous and DC shock-induced subepicardial reentry in isolated, endocardially ablated rabbit hearts. Fluorescent action potential signals were recorded from 2-D subepicardial ventricular myocardium of Langendorff-perfused rabbit hearts. Regional cooling (by 5.9°C ± 1.3°C) was applied to the left ventricular anterior wall using a transparent cooling device (10 mm in diameter). Regional cooling during constant stimulation (2.5 Hz) prolonged the action potential duration (by 36% ± 9%) and slightly reduced conduction velocity (by 4% ± 4%) in the cooled region. Ventricular tachycardias (VTs) induced during regional cooling terminated earlier than those without cooling (control): VTs lasting >30 seconds were reduced from 17 of 39 to 1 of 61. When regional cooling was applied during sustained VTs (>120 seconds), 16 of 33 (48%) sustained VTs self-terminated in 12.5 ± 5.1 seconds. VT termination was the result of rotor destabilization, which was characterized by unpinning, drift toward the periphery of the cooled region, and subsequent collision with boundaries. The DC shock intensity required for cardioversion of the sustained VTs decreased significantly by regional cooling (22.8 ± 4.1 V, n = 16, vs 40.5 ± 17.6 V, n = 21). The major mode of reentry termination by DC shocks was phase resetting in the absence of cooling, whereas it was unpinning in the presence of cooling. Regional cooling facilitates termination of 2-D reentry through unpinning of rotors.
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影响因子：
2.7
作者：
Godemann, F;Butter, C;Behrens, S
通讯作者：
Behrens, S
影响因子：
2
作者：
BIKTASHEV, VN;HOLDEN, AV
通讯作者：
HOLDEN, AV
DOI：
10.1152/ajpheart.00640.2006
发表时间：
2007-01-01
影响因子：
4.8
作者：
Yamazaki, Masatoshi;Honjo, Haruo;Kodama, Itsuo
通讯作者：
Kodama, Itsuo
影响因子：
56.9
作者：
GARFINKEL, A;SPANO, ML;WEISS, JN
通讯作者：
WEISS, JN
影响因子：
158.5
作者：
Buxton, AE;Lee, KL;Hafley, G
通讯作者：
Hafley, G