Reliable pace termination of postoperative atrial fibrillation in the canine sterile pericarditis model: Implications for atypical atrial flutter.
Reliable pace termination of postoperative atrial fibrillation in the canine sterile pericarditis model: Implications for atypical atrial flutter.
复制标题
DOI：
10.1016/j.hroo.2022.01.003
复制
发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Waldo AL
中科院分区：
文献类型：
--
作者：
Lee S;Vitebskiy S;Goldstein RN;Khrestian CM;Waldo AL
我们在犬无菌性心包炎模型中确定了肺静脉区域中的折返回路，其驱动心房，产生代偿性传导，作为术后房颤（POAF）的一种机制。在这个模型中，我们测试了这样一个假设，即从这样一个折返回路处或附近的部位起搏会中断它，从而终止POAF。我们研究了11个无菌心包炎犬术后1-4天。在POAF期间，同时从3个部位记录心房电图（AEGs）：Bachmann束、左心房后壁和右心耳。当记录的AEGs显示有规律的激动时，尝试在该部位终止起搏，方法是以比固有CL短2-5 ms的周期长度（CL）从4次连续搏动开始输送驱动链。诱发16次经心电图诊断为持续性POAF（>5分钟）。在POAF的所有发作期间，从左心房记录的AEG表现出规则的激活，即恒定的AEG形态和CL。当折返性环被起搏器捕获时（平均13 ± 5，范围5-23次），所有16次POAF发作均成功终止。在所有终止事件中，在起搏结束时但在恢复窦性心律之前，在先前组织的部位存在无序的心房激动（平均2秒，范围0.1-8秒）。然而，在没有折返回路（“驱动器”）的情况下，这些搏动不能维持POAF。在持续性POAF期间，从一个表现出规则激动的部位进行超速起搏，通过中断折返回路终止了POAF。
We have identified a reentrant circuit in the pulmonary vein region, which drives the atria, producing fibrillatory conduction, as one mechanism of postoperative atrial fibrillation (POAF) in the canine sterile pericarditis model. In this model, we tested the hypothesis that overdrive pacing from a site at or near such a reentrant circuit would interrupt it and thereby terminate POAF. We studied 11 sterile pericarditis dogs on postoperative days 1–4. Atrial electrograms (AEGs) were recorded during POAF, overdrive pacing, and pace termination from 3 sites simultaneously: Bachmann's bundle, posterior left atrium, and right atrial appendage. When recorded AEGs demonstrated regular activation, pace termination was attempted at that site by delivering a drive train starting with 4 consecutive beats at a cycle length (CL) of 2–5 ms shorter than that of the intrinsic CL. Sixteen episodes of sustained POAF (>5 minutes) diagnosed by electrocardiogram were induced. During all episodes of POAF, AEGs recorded from the left atrium exhibited regular activation, ie, constant AEG morphology and CL. When capture of the reentrant circuit by overdrive pacing occurred (mean 13 ± 5, range 5–23 beats), all 16 POAF episodes were successfully terminated. In all termination episodes, at the end of pacing but prior to the return of sinus rhythm, there was disorganized atrial activation in the previously organized sites (mean 2 seconds, range 0.1–8 seconds). However, these beats did not sustain POAF in the absence of a reentrant circuit (“driver”). Overdrive pacing from a site demonstrating regular activation during sustained POAF terminated the POAF by interrupting the reentrant circuit.
登录
查看更多内容
影响因子：
37.8
作者：
January CT;Wann LS;Alpert JS;Calkins H;Cigarroa JE;Cleveland JC Jr;Conti JB;Ellinor PT;Ezekowitz MD;Field ME;Murray KT;Sacco RL;Stevenson WG;Tchou PJ;Tracy CM;Yancy CW;ACC/AHA Task Force Members
通讯作者：
ACC/AHA Task Force Members
影响因子：
9
作者：
Almassi, GH;Schowalter, T;Hammermeister, KE
通讯作者：
Hammermeister, KE
影响因子：
37.8
作者：
ALLESSIE, M;KIRCHHOF, C;BRUGADA, J
通讯作者：
BRUGADA, J
DOI：
10.1016/0735-1097(90)92835-p
发表时间：
1990-06-01
影响因子：
24
作者：
KAY, GN;MULHOLLAND, DH;PLUMB, VJ
通讯作者：
PLUMB, VJ
影响因子：
6.1
作者：
Sadrpour, Shervin A.;Srinivasan, Deepa;Sahadevan, Jayakumar
通讯作者：
Sahadevan, Jayakumar