Fluorescent imaging of a dual-pathway atrioventricular-nodal conduction system
Fluorescent imaging of a dual-pathway atrioventricular-nodal conduction system
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DOI：
10.1161/01.res.88.3.e23
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发表时间：
2001-02-16
影响因子：
20.1
通讯作者：
Efimov, IR
中科院分区：
文献类型：
--
作者：
Nikoski, V;Efimov, IR
双通道理论解释房室-结（AVN）再入之前已提出。然而，快速通路（FP）和缓慢通路（SP）的确切解剖和功能相关性尚未阐明。在12只家兔的Koch三角形中，我们使用光学成像重建了逆行传导通过AVN和AVN再入期间的激活模式，在6种（50%）的制备中，通过对His束的过早刺激诱导再入，功能性FP和SP似乎与AVN的后外侧延伸和后外侧延伸在解剖学上相关，这最近被描述。6种非诱导制剂的逆行突破点聚集在Koch三角形（FP）的顶点附近，而6种诱导制剂的周期长度依赖于FP和SP出口（n=3）或只有SP出口位于冠状窦口附近。随着耦合间隔的逐渐缩短，突破点从FP向SP的转移伴随着传导曲线的不连续。我们观察到一个涉及AVN、FP、SP以及心房细胞和移行细胞的心内膜浅层的跨壁重入回路。逆行传导过程中功能性SP的存在与AVN再入的诱导性有关。本文全文可在http://www.circresaha.org找到。
A dual-pathway theory to explain atrioventricular-nodal (AVN) reentry has been proposed previously. However, the exact anatomical and functional correlates of the fast pathway (FP) and slow pathway (SP) have not yet been elucidated. We used optical mapping to reconstruct patterns of activation during retrograde conduction through the AVN and during AVN reentry in the triangles of Koch of 12 rabbits, Reentry was inducible by a premature stimulation of the bundle of His in 6 preparations (50%), A functional FP and SP appear to be anatomically correlated with posterior and posterolateral extensions of the AVN, which were recently described. Retrograde breakthrough points in 6 noninducible preparations were clustered near the apex of the triangle of Koch (FP), whereas 6 inducible preparations had either cycle length-dependent FP and SP exits (n=3) or only SP exits located near the coronary sinus orifice. The shift of breakthrough points from FP to SP during progressive shortening of the coupling interval was accompanied by a discontinuity in the conduction curve. We observed a transmural reentrant circuit involving the AVN, FP, SP, and the superficial endocardial layer of atrial and transitional cells. The presence of a functional SP during retrograde conduction was associated with inducibility of AVN reentry. The full text of this article is available at http://www.circresaha.org.