Spiral wave breakup: Optical mapping in an explanted human heart shows the transition from ventricular tachycardia to ventricular fibrillation and self-termination
Spiral wave breakup: Optical mapping in an explanted human heart shows the transition from ventricular tachycardia to ventricular fibrillation and self-termination
复制标题
螺旋波分裂：外植人类心脏的光学测绘显示从室性心动过速到心室颤动和自我终止的转变
DOI：
10.1016/j.hrthm.2022.07.013
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发表时间：
2022
期刊：
影响因子：
5.5
通讯作者：
Fenton, Flavio H.
中科院分区：
文献类型：
--
作者：
Uzelac, Ilija;Iravanian, Shahriar;Bhatia, Neal K.;Fenton, Flavio H.
自1850年Hoffa和Ludwig首次证明通过电刺激诱导心室颤动以来，已经确定了许多启动颤动复杂动力学的机制2，3。我们报告了一个高分辨率可视化的螺旋波过渡到多波在人类心室使用光学映射（电压和钙）从后心外膜表面（w7！在线补充视频1显示了从持续w50次旋转的325-ms周期的相对稳定的功能螺旋波转变为多波（纤颤），其在自我终止之前持续w8秒（主导周期250 ms）。视频在每次转换时都会变慢。虽然不可能在没有壁内信息的情况下确定唯一的作用机制，但这种转变与扭曲的涡丝诱导室颤的假设一致3，4（图1）。长丝
Since the first demonstration of ventricular fibrillation induction by electrical stimulation in 1850 by Hoffa and Ludwig, 1 many mechanisms 2, 3 have been identified that initiate the complex dynamics of fibrillation. We report a high-resolution visualization of a spiral wave transitioning into multiple waves in human ventricles by using optical mapping (voltage and calcium) from the posterior epicardial surface (w7! 7 cm2) of an explanted heart from a 38-yearold female transplant recipient.Online Supplemental Video 1 shows the transition from a relatively stable functional spiral wave of the 325-ms period lasting w50 rotations into multiple waves (fibrillation), which lasted w8 seconds (dominant period 250 ms) before selftermination. The video is slowed down during each transition. While it is impossible to identify the mechanism acting without intramural information uniquely, the transition is consistent with the hypothesis of ventricular fibrillation induction by a twisted vortex filament 3, 4 (Figure 1). Filaments