Simultaneous multisite mapping studies during induced atrial fibrillation in the sterile pericarditis model. Insights into the mechanism of its maintenance.
Simultaneous multisite mapping studies during induced atrial fibrillation in the sterile pericarditis model. Insights into the mechanism of its maintenance.
复制标题
无菌心包炎模型中诱发心房颤动期间的同步多部位标测研究。
DOI：
10.1161/01.cir.95.2.511
复制
发表时间：
1997
期刊：
影响因子：
37.8
通讯作者：
Waldo,AL
中科院分区：
文献类型：
--
作者：
Kumagai,K;Khrestian,C;Waldo,AL
慢性心房颤动（AF）被认为是由多个同时循环的小波引起的。在犬绝育性心包炎模型中，房颤的维持机制尚不清楚。方法和结果在6只无菌心包炎犬的6次AF诱导发作中，使用多路复用系统同时记录了372张单极电图，这些电图来自放置在心房游离壁周围的电极阵列，以及来自房间隔的10至24个电极。分析每只犬一次持续房颤发作（平均持续时间32±24分钟）连续12个100毫秒窗口的激活图。在两只狗中，分析了同一AF发作期间的两个这样的激活图。在房颤期间，主要存在于房间隔和右心房的多个周期长度很短（平均111±8 ms）的不稳定重入回路（平均1.4±0.1个/ 100 ms分析窗口）对房颤的维持负责。不稳定重入回路经常消失并重新形成。从一个心房到另一个心房和/或从房间隔传播的波阵面在不稳定的重入波阵面重构中起重要作用。结论：在这种阵发性房颤模型中，周期长度非常短且主要累及房间隔的不稳定重入回路似乎对房颤的维持至关重要。一些重入回路消失，而另一些重入回路重新形成，因此至少有一个重入回路始终存在。因为心房不能以1:1的方式跟随它们非常短的周期长度，所以AF得以维持。
BackgroundChronic atrial fibrillation (AF) is thought to be due to multiple, simultaneously circulating wavelets. In the canine sterile pericarditis model, the mechanisms of maintenance of AF are not yet understood.Methods and ResultsDuring six induced AF episodes in six dogs with sterile pericarditis, 372 unipolar electrograms were recorded simultaneously from an electrode array placed around both atrial free walls, along with 10 to 24 electrodes from the atrial septum, by use of a multiplexing system. Activation maps during 12 consecutive 100-ms windows were analyzed from an episode of sustained AF in each dog (mean duration, 32±24 minutes). In two dogs, two such activation maps during the same episode of AF were analyzed. During AF, multiple unstable reentrant circuits (mean number, 1.4±0.1 per 100-ms analysis window) with very short cycle lengths (mean, 111±8 ms) present primarily in the atrial septum and right atrium were responsible for maintenance of AF. The unstable reentrant circuits frequently disappeared and re-formed. Wave fronts traveling from one atrium to the other and/or from the atrial septum play an important role in re-formation of unstable reentrant wave fronts.ConclusionsIn this model of paroxysmal AF, unstable reentrant circuits of very short cycle length principally involving the atrial septum appear to be critical for maintenance of AF. Some reentrant circuits disappear as others re-form, so that at least one reentrant circuit is always present. Because the atria cannot follow their very short cycle lengths in a 1:1 manner, AF is maintained.