Gray R. A., Jalife J.
University of Alabama at Birmingham, Cardiac Rhythm Management Laboratory, B140 Volker Hall, 1670 University Boulevard, Birmingham, Alabama 35294-0019.
Chaos. 1998 Mar;8(1):65-78. doi: 10.1063/1.166288.
Although the mechanisms of fibrillation are no doubt multi-faceted, the geometry of the heart may play a major role in the dynamics of wave propagation during fibrillation [A. T. Winfree, Science 266, 1003-1006 (1994)]. The ventricles are thick chambers made up of sheets of parallel muscle fibers with the direction of fibers rotating across the ventricular walls (rotational anisotropy). The thick walls of the ventricles allow reentry to develop transmurally, provided the wavelength is sufficiently small. Depending on the kinetics of heart cells, the dynamics of rotating waves in three dimensions may be fundamentally different than in two dimensions, leading to destabilization of reentry and ventricular fibrillation (VF) in thick ventricles. The atria have an intricate geometry comprised of a thin sheet of cardiac tissue attached to a very complex network of pectinate muscles. The branching geometry of the pectinate muscles may lead to destabilization of two-dimensional reentry via "long-distance" electrical connections giving rise to atrial fibrillation (AF). Therefore, although fibrillation occurs via complex three-dimensional wave propagation in the ventricles and the atria, the underlying mechanisms and factors that sustain VF and AF are probably different.(c) 1998 American Institute of Physics.
尽管颤动的机制无疑是多方面的,但心脏的几何结构可能在颤动期间的波传播动力学中起主要作用[A. T. 温弗里,《科学》266, 1003 - 1006 (1994)]。心室是由平行肌纤维片构成的厚腔室,纤维方向穿过心室壁旋转(旋转各向异性)。心室的厚壁允许跨壁折返的发生,前提是波长足够小。根据心脏细胞的动力学,三维旋转波的动力学可能与二维中的根本不同,导致厚心室中折返和心室颤动(VF)的失稳。心房具有复杂的几何结构,由附着在非常复杂的梳状肌网络上的薄心肌组织片组成。梳状肌的分支几何结构可能通过“远距离”电连接导致二维折返失稳,从而引发心房颤动(AF)。因此,尽管颤动通过心室和心房中复杂的三维波传播发生,但维持VF和AF的潜在机制和因素可能不同。(c) 1998美国物理研究所。