A simple model of the right atrium of the human heart with the sinoatrial and atrioventricular nodes included
A simple model of the right atrium of the human heart with the sinoatrial and atrioventricular nodes included
复制标题
人类心脏右心房的简单模型，包括窦房结和房室结
DOI：
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发表时间：
2013
影响因子：
2.2
通讯作者：
J. Zebrowski
中科院分区：
文献类型：
--
作者：
P. Podziemski;J. Zebrowski
现有的具有详细解剖结构和多变量心脏跨膜电流模型的心房模型太复杂，以至于不能将心律的长时间dycal特性的研究与有效模拟心律失常期间的心脏电活动的能力联合收割机相结合。需要研究其他建模方法。此外，许多最先进的右心房模型不包括房室结（AVN），仅包括很少的窦房结（SAN）。建立了包括SAN和AVN结在内的右心房内心脏组织的模型。为了寻找一个最小的模型，目前我们正在选择众所周知的心律失常来测试我们的方法，这些心律失常到目前为止只使用更复杂的模型来获得，或者只在临床环境中观察到。最终，目标是获得能够生成特定于涉及AV连接的心律失常以及心房内发生的其他现象的RR间期序列的模型。该模型应该足够快，以允许在数千次心跳的时间尺度上实时研究心率变异性和心律失常。在这里提出的右心房模型中，不同种类的心脏组织由不同的方程组描述，其中大多数属于Liénard非线性动力系统类。我们已经开发了一系列具有不同解剖简化的右心房模型，其形式为心房的2D映射或理想化的圆柱形几何形状，仅包括再现给定生理现象所需的解剖细节。模拟允许重建窦性心律和并行收缩源的位置和属性之间的相位关系，以及该源对所得到的心律的影响。我们模拟了在心室触发房性心动过速的电生理研究中观察到的通过房室房室结的动作电位传导时间交替。房室结折返性心动过速的模拟与夹带程序一起进行，其中通过在模拟标测导管上测量起搏后间期（PPI）来定位心律失常回路。RR时间序列的生成和解释是我们研究的最终目标。然而，为了达到这一目标，我们首先需要（1）以某种方式验证包括节点的心房模型的有效性，以及（2）在模型中包括交感神经和迷走神经ANS的作用。本文是对1）的部分解答。特别是，我们表明，在近端（可能是慢传导通路），远端和中距离CS测量PPI-TCL夹带反应可以帮助快速区分AVNRT从其他房性心动过速。我们的模拟支持的假设，交替的传导时间之间的房室顺向往复性心动过速可以发生在一个单一的途径。在心房并行收缩模拟中，我们发现了一个数学条件，该条件允许对心房内并行收缩源的位置进行粗略估计，无论是对于简化的（平面的）心房几何形状还是对于圆柱形的心房几何形状。平面和圆柱形几何形状产生了几乎相同的模拟结果。
Existing atrial models with detailed anatomical structure and multi-variable cardiac transmembrane current models are too complex to allow to combine an investigation of long time dycal properties of the heart rhythm with the ability to effectively simulate cardiac electrical activity during arrhythmia. Other ways of modeling need to be investigated. Moreover, many state-of-the-art models of the right atrium do not include an atrioventricular node (AVN) and only rarely—the sinoatrial node (SAN). A model of the heart tissue within the right atrium including the SAN and AVN nodes was developed. Looking for a minimal model, currently we are testing our approach on chosen well-known arrhythmias, which were until now obtained only using much more complicated models, or were only observed in a clinical setting. Ultimately, the goal is to obtain a model able to generate sequences of RR intervals specific for the arrhythmias involving the AV junction as well as for other phenomena occurring within the atrium. The model should be fast enough to allow the study of heart rate variability and arrhythmias at a time scale of thousands of heart beats in real-time. In the model of the right atrium proposed here, different kinds of cardiac tissues are described by sets of different equations, with most of them belonging to the class of Liénard nonlinear dynamical systems. We have developed a series of models of the right atrium with differing anatomical simplifications, in the form of a 2D mapping of the atrium or of an idealized cylindrical geometry, including only those anatomical details required to reproduce a given physiological phenomenon. The simulations allowed to reconstruct the phase relations between the sinus rhythm and the location and properties of a parasystolic source together with the effect of this source on the resultant heart rhythm. We model the action potential conduction time alternans through the atrioventricular AVN junction observed in cardiac tissue in electrophysiological studies during the ventricular-triggered atrial tachycardia. A simulation of the atrio-ventricular nodal reentry tachycardia was performed together with an entrainment procedure in which the arrhythmia circuit was located by measuring the post-pacing interval (PPI) at simulated mapping catheters. The generation and interpretation of RR times series is the ultimate goal of our research. However, to reach that goal we need first to (1) somehow verify the validity of the model of the atrium with the nodes included and (2) include in the model the effect of the sympathetic and vagal ANS. The current paper serves as a partial solution of the 1). In particular we show, that measuring the PPI–TCL entrainment response in proximal (possibly-the slow-conducting pathway), the distal and at a mid-distance from CS could help in rapid distinction of AVNRT from other atrial tachycardias. Our simulations support the hypothesis that the alternans of the conduction time between the atria and the ventricles in the AV orthodromic reciprocating tachycardia can occur within a single pathway. In the atrial parasystole simulation, we found a mathematical condition which allows for a rough estimation of the location of the parasystolic source within the atrium, both for simplified (planar) and the cylindrical geometry of the atrium. The planar and the cylindrical geometry yielded practically the same results of simulations.
人类心室触发心房起搏过程中复杂的房室结动态。
DOI：
10.1152/ajpheart.2001.281.2.h865
发表时间：
2001
期刊：
American journal of physiology. Heart and circulatory physiology
影响因子：
--
作者：
Christini,DJ;Stein,KM;Markowitz,SM;Mittal,S;Slotwiner,DJ;Iwai,S;Lerman,BB
通讯作者：
Lerman,BB