Clinical and experimental studies of the effects of atrial extrastimulation and rapid pacing on atrial flutter cycle. Evidence of macro-reentry with an excitable gap.
Clinical and experimental studies of the effects of atrial extrastimulation and rapid pacing on atrial flutter cycle. Evidence of macro-reentry with an excitable gap.
复制标题
心房额外刺激和快速起搏对心房扑动周期影响的临床和实验研究。
DOI：
10.1016/0002-9149(81)90139-9
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发表时间：
1981
期刊：
影响因子：
--
通讯作者：
S. Murao
中科院分区：
文献类型：
--
作者：
H. Inoue;H. Matsuo;K. Takayanagi;S. Murao
为探讨人类心房扑动的发生机制，研究了心房起搏和外刺激对心房扑动周期长度的影响。在四个案例中，适当定时的额外刺激缩短了额外刺激后的F-F间期，而不影响刺激包围间期。可兴奋间隙的宽度范围为基本扑动周期长度的14%至25%（平均值±标准差20.4 ± 4.1）。在每例病例中均证实了快速心房起搏的夹带。在16只犬中，按Rosenblueth和Garcia拉莫斯的方法，在上级和下腔静脉之间放置障碍物，电刺激诱发心房扑动。在11只狗中，额外刺激缩短了F-F间期，与临床研究中的刺激包围间期相邻。在6只狗中测量的可兴奋间隙范围为基本扑动周期长度的15%至24%（平均20.6 ± 3.0）。在6只狗的研究中观察到夹带，在夹带过程中，心房激动序列几乎是相同的，在基本扑动cycle.It的结论是，缩短F-F间期旁边的刺激包围的间隔，不受影响，有利于宏折返作为人类心房扑动的机制。
To investigate the mechanism of atrial flutter in human beings, effects of atrial pacing and extrastimulation on flutter cycle length were studied. In four cases, properly timed extrastimuli shortened the F-F interval after the extrastimulus without affecting the stimulus-encompassing interval. The width of the excitable gap ranged from 14 to 25 percent of the basic flutter cycle length (mean ± standard deviation 20.4 ± 4.1). Entrainment to rapid atrial pacing was demonstrated in each case. The width of the entrainment zone nearly coincided with that of the excitable gap in each case.In 16 dogs, atrial flutter was induced by electrical stimulation after an obstacle was placed between the superior and the inferior venae cavae according to Rosenblueth and Garcia Ramos. In 11 dogs, extrastimuli shortened the F-F interval next to the stimulus-encompassing interval as in the clinical study. The excitable gap, measured in six dogs, ranged from 15 to 24 percent of the basic flutter cycle length (mean 20.6 ± 3.0). Entrainment was observed in six dogs studied and, during entrainment, the atrial activation sequence was almost the same as that during the basic flutter cycle.It is concluded that shortening of the F-F interval next to the stimulus-encompassing interval that is not affected favors macro-reentry as the mechanism of atrial flutter in human beings.