Quantitative assessment of the spatial organization of atrial fibrillation in the intact human heart
Quantitative assessment of the spatial organization of atrial fibrillation in the intact human heart
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DOI：
10.1161/01.cir.93.3.513
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发表时间：
1996-02-01
期刊：
影响因子：
37.8
通讯作者：
Smith, JM
中科院分区：
文献类型：
--
作者：
Botteron, GW;Smith, JM
心房颤动（AF）期间的心房激动通常被描述为随机或混沌的。我们认为AF期间的激活受到重入兴奋原则的约束;这些约束赋予AF期间激活可测量的空间组织;并且激动序列保持良好相关的距离可以容易地测量，并且与AF维持自身的倾向以及心房组织波长相关。对接受电生理学研究的患者右心房五个等距部位记录的激动序列相关性进行量化的处理技术。在20例房颤患者中（12例阵发性房颤，5例慢性房颤，3例无房颤临床病史），11 mm时平均相关系数为0.54+/-0.12，44 mm时平均相关系数为0.32+/-0.11，而窦性心律时平均相关系数为0.95+/-0.023，0.91+/-0.023。在AF中，位移与距离的关系是单调递减的，很好地拟合衰减指数函数。该指数函数的空间常数称为激活空间常数，提供了AF期间激活空间组织的单一客观度量。该组的平均激活空间常数为2.6+/-1.15 cm。慢性房颤患者的平均激活空间常数最低（1.84 ± 0.36 cm），无房颤病史的房颤患者的平均激活空间常数最高（3.06 ± 0.40 cm）（P
Background Atrial activation during atrjal fibrillation (AF) is frequently described as random or chaotic. We propose that activation during AF is constrained by the principles of reentrant excitation; that these constraints impart a measurable spatial organization to activation during AF; and that the distance over which activation sequences remain well correlated can be readily measured and related both to the propensity of AF to sustain itself as well as to atrial tissue wavelength.Methods and Results We describe a novel signal-processing technique that quantifies the correlation in activation sequences recorded from five equally spaced sites in the right atrium in patients undergoing electrophysiology studies. In 20 patients in AF (12 with paroxysmal AF, 5 with chronic AF, and 3 withno clinical history of AF), the average correlation was 0.54+/-0.12 at 11 mm and 0.32+/-0.11 at 44 mm, compared with 0.95+/-.023 and 0.91+/-.023 in sinus rhythm. In AF, the correla tion versus distance relation was monotonically decreasing, well fit by a decaying exponential function. The space constant of this exponential function, termed the activation space constant, provides a single objective metric of the spatial organization of activation during AF. The mean activation space constant for the group was 2.6+/-1.15 cm. Chronic AF had the lowest mean activation space constant (1.84+/-0.36 cm) and AF in patients with no prior history of AF had the highest (3.06+/-0.40 cm) (P