Effects of three dimensional electrical properties on the mechanisms of initiation, maintenance, and termination of atrial fibrillation ; clinical and computer simulation study

三维电特性对心房颤动的引发、维持和终止机制的影响；

• 批准号: 12670660
• 负责人: ITO Makoto
• 金额: $ 2.18万
• 依托单位: SHIGA UNIVERSITY OF MEDICAL SCIENCE
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2000
• 资助国家: 日本
• 起止时间: 2000 至 2001
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-12670660/
• 关键词: Fibrillation; Spiral wave; Scroll wave; Computer simulation; Rotational anisotropy; Breakthrough wave; Ion channel; Functional reentry; Rreakthrough wave; Electro-Anatomical Mapping; Computer Simulation

In order to analyze the mechanism of fibrillation, we simulated an environment of two and three dimensional wall tissue with fiber twists of 0℃ to 120℃, from the endocardium to the epicardium employing Luo-Rudy Phase I equations. In a twisted three dimensional model, the scroll waves were demonstrated as multiple wavelets scattered spatiotemporally, frequently accompanied by breakthrough waves that were promoted by rotational anisotropy.We observed the dynamics of spiral waves (SW) on the two-dimensional tissue environment employing Luo-Rudy II equations. Intracellular concentration of Ca ion increased during spiral wave reentry, then DADs were induced. Rotating spiral wave front disturbed by DADs and broke up, leading to a high incidence of transition from tachycardia to fibrillation. DADs play an important role in the genesis of fibrillation. In contrast, reducing the potassium channel current tended to organize the SW, and when reduced 60 % of the standard value, SW reentry terminated because the SW tip lost its stability. The SW tip meandered along the functional block line or the SW tip collided with the tissue boundary. Further reduction of 1-K, it became difficult to generate the SW reentry due to prolonged functional block line.In the clinical studies, we sometimes observed the scar tissue in the right and/or left atrium. Anisotropic conduction was found in such cases. Reentrant tachycardia around the scar tissue occasionally generated fibrillation. Other mechanisms, such as automatic atrial ectopies and repetitive activities in the pulmonary veins, were observed in the patients with paroxysmal atrial fibrillation.Further clinical and experimental studies are necessary to understanding the mechanism of atrial fibrillation.

为了分析纤颤的发生机制，我们用罗鲁迪第一相方程模拟了从心内膜到心外膜的二维和三维壁组织的纤维缠绕0℃到12 0℃的环境。在扭曲的三维模型中，涡旋波表现为多个小波在空间上的散射，并经常伴随着由旋转各向异性推动的穿透波。螺旋波重入时细胞内钙离子浓度升高，诱发DADS。旋转的螺旋波前受到爸爸的干扰而破裂，导致心动过速向纤颤过渡的高发。父亲在纤颤的发生中扮演着重要的角色。相反，降低钾通道电流倾向于组织短波，当降低标准值的60%时，短波再入终止，因为短波尖端失去了稳定性。西南尖端沿着功能阻滞线蜿蜒或与组织边界碰撞。1-K进一步缩小，由于功能阻滞线的延长，很难产生西南折返。在临床研究中，我们有时会观察到右和/或左心房的瘢痕组织。在这些情况下发现了各向异性的传导。疤痕组织周围的折返性心动过速偶尔会产生纤颤。阵发性房颤患者还可观察到自发性房颤和肺静脉重复活动等机制，需要进一步的临床和实验研究才能了解房颤的发病机制。

项目成果

Ahihara T., Yao T., Namba T., Ito M., Ikeda T., Kawase A., Toda S., Suzuki T., Inagaki M., Sugimachi M., Kinoshita M., Nakazawa K.: "Electroporation in a model of cardiac defibrillation"Journal of Cardiovascular Electrophysiology. 12・12. 1393-1403 (2001)

Ahihara T.、Yao T.、Namba T.、Ito M.、Ikeda T.、Kawase A.、Toda S.、Suzuki T.、Inagaki M.、Sugimachi M.、Kinoshita M.、Nakazawa K.：“电穿孔心脏除颤模型”心血管电生理学杂志. 12・12. 1393-1403 (2001)

Takashi Ashihara,Makoto Ito,Masahiko Kinoshita et al: "Rotational Anisotropy Promotes Breakthrough-woves in Left Vintricle during Fibrillation : A Simulation Study"Journal of Cardiovascular Electrophysiology. (in press). (2001)

Takashi Ashihara、Makoto Ito、Masahiko Kinoshita 等人：“旋转各向异性促进纤维颤动期间左室突破编织：模拟研究”心血管电生理学杂志。

芦原貴司,難波経豊,山田直子,杉本喜久,伊藤誠,木之下正彦 他: "コンピュータシミュレーションによるIII群抗不整脈薬のSqiral wave停止効果の検討"Japanese circulation Journal. 64(Suppl.I). 573 (2000)

Takashi Ashihara、Tsunetoyo Namba、Naoko Yamada、Yoshihisa Sugimoto、Makoto Ito、Masahiko Kinoshita 等：“通过计算机模拟检查 III 类抗心律失常药物的 Sqiral 波停止效应”日本流通杂志 64（增刊 I）。 (2000)

Takashi Ashihara,Makoto Ito,Masahiko Kinosito 他(分担): "Clinical Application of Computationary Mechanics to the Cardiovascular System"Springer-Verlag Tokyo, T.Yamaguchi (ed). 288 (2000)

Takashi Ashihara、Makoto Ito、Masahiko Kinosito 等人（撰稿人）：“计算力学在心血管系统中的临床应用”Springer-Verlag Tokyo，T. Yamaguchi（编）288（2000 年）。

Ashihara T, Namba T, Ikeda T, Ito M, Kinoshita M, Nakazawa K: "Breakthrough waves during ventricular fibrillation depend on the degree of rotational anisotropy and the boundary conditions : A simulation study"Journal of Cardiovascular Electrophysiology. 1

Ashihara T、Namba T、Ikeda T、Ito M、Kinoshita M、Nakazawa K：“心室颤动期间的突破波取决于旋转各向异性的程度和边界条件：模拟研究”心血管电生理学杂志。