Phase Mapping of Cardiac Fibrillation
Phase Mapping of Cardiac Fibrillation
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DOI：
10.1161/circep.110.853804
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发表时间：
2010-02-01
影响因子：
8.4
通讯作者：
Nanthakumar, Kumaraswamy
中科院分区：
文献类型：
--
作者：
Umapathy, Karthikeyan;Nair, Krishnakumar;Nanthakumar, Kumaraswamy
相位是通过动作电位跟踪心肌的定义区域的进展的描述符，并且已被证明是分析纤颤期间时空变化的有效参数。在这篇综述中，相位映射背后的基本原理主要是在心室颤动（VF），心房颤动（AF）和实验单层数据的颤动的背景下。在纤颤期间，相位分布随时间变化，这取决于激活模式。分析这些相位模式为我们提供了对心脏动力学的深入了解，并有助于阐明心脏颤动和干预调节的机制。Winfree 1在80年代后期引入了相位分析来研究心脏颤动。这种时间编码技术处理的情况下，激活周期是相同的表面被映射。为了处理在标测表面上不同激活周期的场景（常见于动物和人类纤维性颤动模型），Gray等人2，3从非线性动力学引入了状态空间编码概念。在分析VF期间心脏表面的电或光学标测构建的时空相位图时，相位从π到π的完整周期的点非常感兴趣。在这些点上，相位变得不确定，激活波前铰接到这些点，并以有组织的方式围绕它们旋转。相位图中的这些点被称为相位奇点（PS）点。Bray等人4开发了一种在相位图中定位PS点的程序。Nash等人5使用相位标测研究了人类心脏的整个心室心外膜，其中袜子包含256个单极接触电极。这种相位映射工具的开发已经导致更好地理解颤动动力学，如通过使用相位映射检测PS及其在VF期间展示组织的作用所证明的。这些工作和他们的发现包括：（1）PS与解剖不均匀性共定位，它们的空间蜿蜒受到这些不均匀性的调制;（2）PS与波破裂的位置相关;（3）在肌病人类心脏中，相位图被用来显示电活动的组织
Phase is a descriptor that tracks the progression of a defined region of myocardium through the action potential and has been demonstrated to be an effective parameter in analyzing spatiotemporal changes during fibrillation. In this review, the basic principles behind phase mapping are presented mainly in the context of ventricular fibrillation (VF), atrial fibrillation (AF), and fibrillation from experimental monolayer data. During fibrillation, the phase distribution changes over time, depending on activation patterns. Analyzing these phase patterns provides us insight into the fibrillatory dynamics and helps clarify the mechanisms of cardiac fibrillation and modulation by interventions. Winfree1 introduced the phase analysis to study cardiac fibrillation in the late eighties. This time-encoding technique deals with a scenario where the activation periods are the same over the surface being mapped. To deal with the scenario of varying activation period over the mapped surface (common in animal and human fibrillation models), Gray et al2, 3 introduced the state-space encoding concept from nonlinear dynamics.In analyzing spatiotemporal phase maps constructed from electric or optical mapping of the surface of heart during VF, points around which the phase progresses through a complete cycle from π to π are of great interest. At these points, the phase becomes indeterminate and the activation wave fronts hinge to these points and rotate around them in an organized fashion. These points in the phase map are called phase singularity (PS) points. Bray et al4 developed a procedure to locate PS points in a phase map. Nash et al5 used phase mapping to study the entire ventricular epicardium of human hearts with a sock containing 256 unipolar contact electrodes. The development of this phase mapping tool has led to better understanding of fibrillation dynamics as evidenced by the use of phase mapping in detecting PS and their role in demonstrating organization during VF. Some of these works and their findings are (1) PS colocalize with anatomic heterogeneities, and their spatial meandering is modulated by these heterogeneities, 6 (2) PS correlates with the locations of wave breaks, 7 (3) in myopathic human hearts, phase maps were used to show that the organization of electric activity