Attachment of meandering reentrant wave fronts to anatomic obstacles in the atrium. Role of the obstacle size.
Attachment of meandering reentrant wave fronts to anatomic obstacles in the atrium. Role of the obstacle size.
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蜿蜒折返波前与心房解剖障碍的附着。
DOI：
10.1161/01.res.81.5.753
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发表时间：
1997
影响因子：
20.1
通讯作者：
Karagueuzian,HS
中科院分区：
文献类型：
--
作者：
Ikeda,T;Yashima,M;Uchida,T;Hough,D;Fishbein,MC;Mandel,WJ;Chen,PS;Karagueuzian,HS
氯化乙酰胆碱（ACh）在心房中诱导非平稳曲折折返波前。我们假设，一个合适大小的解剖障碍物，防止曲折引起附件的折返波前端的障碍。8个离体犬右心房组织（面积3.8× 3.2cm）置于组织浴槽中，用含10 ~ 15 μmol/LACh的Tyrode液灌流。用活检打孔器在组织中心依次创建直径为2- 10 mm的孔。在400 ms周期长度的8次常规刺激后，通过过早刺激诱导折返。使用509个双极电极在每个测试损伤之前和之后动态可视化内循环激活图和诱导折返的运动。在没有病变的情况下（n=8），诱导的单重入波前，在螺旋波的形式，蜿蜒不规则地从一个部位到另一个，然后终止于组织边界。直径为2- 4 mm的孔（n=6）对弯曲没有影响。然而，当孔直径增加到6 mm（n=8），8 mm（n=8）和10 mm（n=6）时，螺旋波的尖端附着在孔上，并且再入变得静止。从弯曲状态到附着状态的转变将不规则和多态性电描记图转换为周期性和单态性活动，周期长度更长（无孔与10 mm孔分别为101±11与131±9 ms;P<.001）。回归分析显示，折返周期长度与孔直径（r=.89，P <.01）和可兴奋间隙（r=.89，P <.05）呈显著正相关。我们的结论是，一个临界尺寸的解剖障碍转换为一个固定的一个非静止的曲折折返波前。这种转变将不规则的“原纤化样”活性转化为规则的单态活性。
Acetylcholine chloride (ACh) induces nonstationary meandering reentrant wave fronts in the atrium. We hypothesized that an anatomic obstacle of a suitable size prevents meandering by causing attachment of the reentrant wave front tip to the obstacle. Eight isolated canine right atrial tissues (area, 3.8×3.2 cm) were mounted in a tissue bath and superfused with Tyrode’s solution containing 10 to 15 μmol/L ACh. Holes with 2- to 10-mm diameters were sequentially created in the center of the tissue with biopsy punches. Reentry was induced by a premature stimulus after eight regular stimuli at 400-ms cycle length. The endocardial activation maps and the motion of the induced reentry were visualized dynamically before and after each test lesion using 509 bipolar electrodes. In the absence of a lesion (n=8), the induced single reentrant wave front, in the form of a spiral wave, meandered irregularly from one site to another before terminating at the tissue border. Holes with 2- to 4-mm diameters (n=6) had no effect on meandering. However, when the hole diameters were increased to 6 mm (n=8), 8 mm (n=8), and 10 mm (n=6), the tip of the spiral wave attached to the holes, and reentry became stationary. Transition from meandering to an attached state converted the irregular and polymorphic electrogram to a periodic and monomorphic activity with longer cycle lengths (101±11 versus 131±9 ms for no hole versus 10-mm hole, respectively;P<.001). Regression analysis showed a significant positive linear correlation between the cycle length of the reentry and the hole diameter (r=.89,P<.01) and between the cycle length of the reentry and the excitable gap (r=.89,P<.05). We conclude that a critically sized anatomic obstacle converts a nonstationary meandering reentrant wave front to a stationary one. This transition converts an irregular “fibrillation-like” activity into regular monomorphic activity.
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影响因子：
3.4
作者：
J. Starobin;Y. Zilberter;E. M. Rusnak;C. Starmer
通讯作者：
J. Starobin;Y. Zilberter;E. M. Rusnak;C. Starmer
影响因子：
20.1
作者：
PERTSOV, AM;DAVIDENKO, JM;JALIFE, J
通讯作者：
JALIFE, J
影响因子：
56.9
作者：
GRAY, RA;JALIFE, J;PERTSOV, AM
通讯作者：
PERTSOV, AM
影响因子：
37.8
作者：
GRAY, RA;JALIFE, J;PERTSOV, AM
通讯作者：
PERTSOV, AM
影响因子：
3.4
作者：
Cabo, C;Pertsov, AM;Jalife, J
通讯作者：
Jalife, J