The atrial flutter reentrant circuit. Additional pieces of the puzzle.
The atrial flutter reentrant circuit. Additional pieces of the puzzle.
复制标题
心房扑动折返回路。
DOI：
10.1161/01.cir.94.3.244
复制
发表时间：
1996
期刊：
影响因子：
37.8
通讯作者：
A. Waldo
中科院分区：
文献类型：
--
作者：
G. V. Van Hare;A. Waldo
有一段时间，有一个很大的学派认为房扑是由于一个单一的焦点快速放电。1最近已经确定房扑是由于折返。1多年来，主要是基于动物研究，心房扑动折返回路的性质已经被认为或证明包括围绕解剖学障碍的折返肺静脉、心房病变周围折返和功能障碍周围折返。2三尖瓣环周围折返在存在严重右心房病变时得到证实。3多年前，托马斯刘易斯爵士仅能通过假设二尖瓣环周围折返来解释犬模型中有限的连续部位房扑标测图。4然而，现在公认的是，患者中的典型（I型）心房扑动是由于涉及右心房的大折返。1患者中典型形式的心房扑动的初始激动标测研究显示右心房中的“逆时针”折返激动，5 6 7，但右心房的元素，支持折返，是至关重要的维护房扑折返电路尚未得到赞赏。
通过使用隐蔽性牵拉技术8以及消融性病变精确定位技术的研究，现已明确，房扑折返回路的一个关键要素是下腔静脉和三尖瓣环之间的峡部。两项仔细进行的研究提供了关于折返环路关键元件的额外重要细节。10 11这两项研究都依赖于隐蔽的概念，以支持某些心房部位是否为房扑折返回路的一部分的结论。…
For a time, there was a substantial school of thought that held that atrial flutter was due to a single focus firing rapidly.1 It has more recently been established that atrial flutter is due to reentry.1 Over the years, and largely on the basis of animal studies, the nature of the atrial flutter reentrant circuit has been thought or demonstrated to include reentry around anatomic obstacles such as the great veins or the pulmonary veins, reentry around atrial lesions, and reentry around functional obstacles.2 Reentry around the tricuspid annulus was demonstrated in the presence of critical right atrial lesions,3 and many years ago, Sir Thomas Lewis could only explain a limited sequential site atrial flutter map in a canine model by postulating reentry around the mitral annulus.4 However, it is now accepted that classic (type I) atrial flutter in patients is due to macroreentry involving the right atrium.1 Initial activation mapping studies of the typical form of atrial flutter in patients showed a “counterclockwise” reentrant activation in the right atrium,5 6 7 but the elements of the right atrium that supported reentry and were critical to the maintenance of the atrial flutter reentrant circuit were not yet appreciated.
From studies using concealed entrainment techniques8 as well as techniques for precise placement of ablative lesions, it is now well established that one critical element of the atrial flutter reentrant circuit is the isthmus between the inferior vena cava and the tricuspid valve annulus.9 In this issue of Circulation , two carefully performed studies provide additional important details concerning the critical elements of the reentrant circuit.10 11 Both studies rely on the concept of concealed entrainment to support conclusions involving whether certain atrial sites are part of the atrial flutter reentrant circuit. …
心房颤动、心房扑动和异位房性心动过速的机制——简要回顾。
影响因子：
37.8
作者：
Waldo,AL
通讯作者：
Waldo,AL