Role of pectinate muscle bundles in the generation and maintenance of intra-atrial reentry - Potential implications for the mechanism of conversion between atrial fibrillation and atrial flutter
Role of pectinate muscle bundles in the generation and maintenance of intra-atrial reentry - Potential implications for the mechanism of conversion between atrial fibrillation and atrial flutter
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DOI：
10.1161/01.res.83.4.448
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发表时间：
1998-08-24
影响因子：
20.1
通讯作者：
Chen, PS
中科院分区：
文献类型：
--
作者：
Wu, TJ;Yashima, M;Chen, PS
采用含有1 ~ 2.5 μ mol/L乙酰胆碱（ACh）的Tyrode溶液灌注10只离体犬右心房组织，以确定果胶肌束（PM）在房内再入形成中的作用。使用477个分辨率为1.6 mm的双极电极绘制心内膜。再入由过早刺激诱导（S-2）。计算机模拟研究用于研究心肌再入层厚度在心肌再入层形成中的重要性。共诱发40次再入；静止再入是在S-2刺激后立即诱导的（n=9），或在持续1460±1077 ms的初始不规则激活期后诱导的（n=19）。在28次发作中，20次由沿大PM脊的传导阻滞引起，导致波浪破裂并开始再入。它的再入波保持静止，并围绕这些山脊旋转，作为锚定点。在从最初的不规则激活到静止再入的过渡过程中，电图形态从“纤颤样”活动转变为“颤振样”活动。在8个事件中，由于外部波锋的干扰（n=5）或波与脊的自发分离（n=3），最初的平稳再入转变为不规则激活。与平稳再入相比，非平稳再入总是发生在没有大pm的区域，平均寿命要短得多(102 +/- 151相对于3.8 +/- 1.1旋转，P
To determine the role of pectinate muscle (PM) bundles in the formation of intra-atrial reentry, 10 isolated canine right atrial tissues were perfused with Tyrode's solution containing 1 to 2.5 mu mol/L acetylcholine (ACh). The endocardium was mapped using 477 bipolar electrodes with 1.6-mm resolution. Reentry was induced by a premature stimulus (S-2). Computer simulation studies were used to investigate the importance of regional myocardial thickness in reentry formation. A total of 40 episodes of reentry were induced; 28 episodes were stationary, and the remaining 12 were nonstationary, The stationary reentry was induced either immediately after the S-2 stimuli (n=9) or after an initial period of irregular activations that lasted 1460 +/- 1077 ms (n=19). Of 28 episodes, 20 were initiated by conduction block along large PM ridges, leading to wave break and the initiation of reentry. The reentrant wave fron ts remained stationary and rotated around these ridges as anchoring sites. During the transition from the initial irregular activations to stationary reentry, the electrogram morphology converted from "fibrillation-like'' to "flutter-like" activity. In 8 episodes, initially stationary reentry converted to irregular activations because of interference with outside wave fronts (n=5) or spontaneous separation of waves from the ridges (n=3), Compared with stationary reentry, nonstationary reentry always occurred over an area without large PMs, and the mean life span was much shorter (102 +/- 151 versus 3.8 +/- 1.1 rotations, P