Rogers Jack M, Huang Jian, Melnick Sharon B, Ideker Raymond E
Departments of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, Ala, USA.
Circ Res. 2003 Mar 21;92(5):539-45. doi: 10.1161/01.RES.0000061569.23879.20. Epub 2003 Feb 13.
It has been proposed that ventricular fibrillation (VF) is driven by sustained reentry. However, mapping studies have not detected such "mother rotors" in large mammalian hearts. We mapped VF from three 21x12 unipolar electrode arrays in 6 pigs. Two of the arrays were adjacent to each other on the left-ventricular epicardium. Electrode spacing was 2 mm. The third array consisted of 21 needles (0.5-mm diameter, 12 electrodes, 1-mm spacing) inserted in a row (2-mm spacing) between the epicardial arrays. A total of 88 5-second VF epochs were analyzed with automatic reentry detection algorithms. Although intramural reentry was sporadically present (29 total occurrences), it was always short-lived with a mean life span of 127+/-57 ms. However, in 3 of the 6 animals, sustained epicardial reentry (ie, reentry persisting for more than a few cycles) was consistently present, often lasting for several seconds. For each epoch, we computed indices characterizing (1) the relative duration of reentry on the two epicardial arrays (R), (2) the flow of wavefronts between epicardial arrays (W), and (3) the relative activation rates of the two epicardial arrays (F). R did not correlate with either W or F indicating that rotor-containing regions did not produce a net outflow of wavefronts and were not faster than neighboring regions. Thus, sustained epicardial, but not intramural, rotors were consistently present in some large animal hearts during VF. However, we found no evidence that these rotors were responsible for sustaining VF through the mechanisms outlined in the mother rotor hypothesis.
有人提出心室颤动（VF）是由持续的折返驱动的。然而，标测研究在大型哺乳动物心脏中并未检测到这种“母转子”。我们使用三个21×12单极电极阵列对6头猪的室颤进行了标测。其中两个阵列在左心室心外膜上彼此相邻。电极间距为2毫米。第三个阵列由21根针（直径0.5毫米，12个电极，间距1毫米）排成一排（间距2毫米）插入心外膜阵列之间。使用自动折返检测算法对总共88个5秒的室颤时段进行了分析。尽管壁内折返偶尔出现（总共29次），但总是短暂的，平均寿命为127±57毫秒。然而，在6只动物中的3只中，持续的心外膜折返（即折返持续多个周期以上）持续存在，通常持续数秒。对于每个时段，我们计算了表征以下方面的指标：（1）两个心外膜阵列上折返的相对持续时间（R），（2）心外膜阵列之间波前的流动（W），以及（3）两个心外膜阵列的相对激活率（F）。R与W或F均无相关性，表明含有转子的区域不会产生波前的净流出，且不比相邻区域更快。因此，在室颤期间，一些大型动物心脏中持续存在心外膜而非壁内的转子。然而，我们没有发现证据表明这些转子通过母转子假说中概述的机制维持室颤。
