Kawai S, Ih S, Koizumi K
Department of Internal Medicine, Juntendo University School of Medicine, Tokyo.
J Cardiol. 1999 Mar;33 Suppl 1:47-52.
Atrial fibrillation is one of the most common arrhythmias which is associated with various organic heart diseases or systemic disorders. Although a pathological basis for atrial fibrillation has not been clarified, an anatomical substrate corresponding to long-term atrial fibrillation has been recently demonstrated. Age-related changes of the atrial myocardium were frequently observed in healthy people. Quantitative histological study of the sinoatrial node revealed no difference in the reduction of the nodal cells between 12 patients with atrial fibrillation and 21 age-matched controls. The pathological findings of the myocardium including atrial preferential pathways in patients with long-term atrial fibrillation showed depletion of the muscular bundles, fibrosis and fatty metamorphosis of the atrial myocytes. These findings suggest that atrial fibrillation might be related to reentry in the residual muscular bundles including circumferential muscular bundles in the right atrium.
心房颤动是最常见的心律失常之一，与各种器质性心脏病或全身性疾病相关。尽管心房颤动的病理基础尚未阐明，但最近已证实存在与长期心房颤动相对应的解剖学基质。在健康人群中经常观察到心房心肌的年龄相关变化。对窦房结的定量组织学研究显示，12例心房颤动患者与21例年龄匹配的对照组之间，结细胞减少无差异。长期心房颤动患者心肌的病理表现，包括心房优先传导通路，显示肌束减少、心房肌细胞纤维化和脂肪变性。这些发现表明，心房颤动可能与右心房包括环周肌束在内的残余肌束中的折返有关。
