Early afterdepolarizations and cardiac arrhythmias.

Early afterdepolarizations and cardiac arrhythmias.
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DOI:
10.1016/j.hrthm.2010.09.017
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发表时间:
2010-12
期刊:
影响因子:
5.5
通讯作者:
Qu, Zhilin
Qu, Zhilin
中科院分区:
医学2区
文献类型:
--
作者:
Weiss, James N.;Garfinkel, Alan;Karagueuzian, Hrayr S.;Chen, Peng-Sheng;Qu, Zhilin

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早期后除极(埃兹)是长QT综合征和心力衰竭中致死性室性心律失常的重要原因,但埃兹在细胞水平引起心律失常(如组织水平的多形性室性心动过速(PVT)和尖端扭转型室性心动过速(TdP))的机制尚不清楚。在这里,我们总结了这一领域的最新进展,讨论i)埃兹的离子基础,ii)埃兹的不规则行为的确定性混沌基础的证据,iii)混沌埃兹在组织中大量耦合细胞中同步以克服源-库失配的机制,v)该同步过程如何允许埃兹启动触发并产生PVT和TdP基础的混合局灶性折返性室性心律失常,和vi)治疗意义。
Early afterdepolarizations (EADs) are an important cause of lethal ventricular arrhythmias in long QT syndromes and heart failure, but the mechanisms by which EADs at the cellular scale cause arrhythmias such as polymorphic ventricular tachycardia (PVT) and Torsades de Pointes (TdP) at the tissue scale are not well-understood. Here we summarize recent progress in this area, discussing i) the ionic basis of EADs, ii) evidence that deterministic chaos underlies the irregular behavior of EADs, iii) mechanisms by which chaotic EADs synchronize in large numbers of coupled cells in tissue to overcome the source-sink mismatches, v) how this synchronization process allows EADs to initiate triggers and generate mixed focal-reentrant ventricular arrhythmias underlying PVT and TdP, and vi) therapeutic implications.
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