Roux N, Havet E, Mertl P
Service de chirurgie thoracique et cardio-vasculaire, Hôpital Charles Nicolle, CHU de Rouen, 1 rue Germont, 76000, Rouen, France.
Surg Radiol Anat. 2004 Aug;26(4):285-9. doi: 10.1007/s00276-003-0219-6. Epub 2004 Feb 11.
Atrial fibrillation (AF) is the most common abnormal heart rhythm and contributes to cardiac morbidity and mortality. Electrophysiological studies with pacing have shown that AF is initiated by ectopic beats localized in the pulmonary vein (PV) walls. The aim of this work was to look for some anatomical or histological particularities to explain these ectopic beats. Ten autopsied hearts were examined (6 males, 4 females). The myocardium was studied from the left atrium to the PV. Histological sections were made from 39 PVs. Myocardial cells were localized to PV between 9 and 38 mm from the PV-atrial junction. The sleeve was composed of circularly and longitudinally oriented bundles of cardiomyocytes. The peripheral end of the myocardial sleeve was irregular. The longest myocardial sleeves were found in the superior veins and were longitudinally oriented. At the PV-atrial junction, the circular bundles were not often circumferential. PV myocardial architecture confirmed the possibility of initiating AF. This fact is important for therapeutic radiofrequency ablation and explains why PV disconnection is essential.
心房颤动（AF）是最常见的心律失常，会导致心脏发病和死亡。起搏电生理研究表明，AF由位于肺静脉（PV）壁的异位搏动引发。这项工作的目的是寻找一些解剖学或组织学特征来解释这些异位搏动。检查了10个尸检心脏（6例男性，4例女性）。从左心房到PV对心肌进行了研究。对39条PV制作了组织学切片。心肌细胞位于距PV-心房交界处9至38毫米的PV内。肌袖由呈环状和纵向排列的心肌细胞束组成。心肌袖的外周端不规则。最长的心肌袖见于上肺静脉，且呈纵向排列。在PV-心房交界处，环状束并不常呈圆周状。PV心肌结构证实了引发AF的可能性。这一事实对治疗性射频消融很重要，并解释了为什么PV隔离至关重要。
