Wu Tsu-Juey, Lin Shien-Fong, Baher Ali, Qu Zhilin, Garfinkel Alan, Weiss James N, Ting Chih-Tai, Chen Peng-Sheng
Cardiovascular Center, Taichung Veterans General Hospital and Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Circulation. 2004 Oct 12;110(15):2110-8. doi: 10.1161/01.CIR.0000143834.51102.91. Epub 2004 Oct 4.
Two types of ventricular fibrillation (VF) have been demonstrated in isolated rabbit hearts during D600 infusion. Type 1 VF is characterized by the presence of multiple, wandering wavelets, whereas type 2 VF shows local spatiotemporal periodicity. We hypothesized that a single mother rotor underlies type 2 VF.
One (protocol I) or 2 (protocol II) cameras were used to map the epicardial ventricular activations in Langendorff-perfused rabbit hearts. Multiple episodes of type 2 VF were induced in 22 hearts by high-concentration (> or =2.5 mg/L) D600 (protocol I). During type 2 VF, a single spiral wave (n=19) and/or an epicardial breakthrough pattern (n=11) was present in 14 hearts. These spiral waves either slowly drifted or intermittently anchored on the papillary muscle (PM) of the left ventricle. Dominant-frequency (DF) analyses showed that the highest local DF was near the PM (12.5+/-1.1 Hz). There was an excellent correlation between the highest local DF of these spiral waves and breakthroughs (11.8+/-1.7 Hz) and the DF of simultaneously obtained global pseudo-ECG (11.2+/-1.8 Hz, r=0.97, P<0.0001) during type 2 VF. We also successfully reproduced the major features of type 2 VF by using the Luo-Rudy action-potential model in a simulated, 3-dimensional tissue slab, under conditions of reduced excitability and flat action-potential duration restitution.
Either a stationary or a slowly drifting mother rotor can result in type 2 VF. Colocalization of the stationary mother rotors with the PM suggests the importance of underlying anatomic structures in mother rotor formation.
在离体兔心脏灌注D600期间已证实存在两种类型的心室颤动（VF）。1型VF的特征是存在多个游走小波，而2型VF表现出局部时空周期性。我们假设2型VF由单个母转子构成。
使用1台（方案I）或2台（方案II）摄像机绘制Langendorff灌注兔心脏的心外膜心室激动图。通过高浓度（≥2.5mg/L）D600在22颗心脏中诱发多次2型VF发作（方案I）。在2型VF期间，14颗心脏中存在单个螺旋波（n = 19）和/或心外膜突破模式（n = 11）。这些螺旋波要么缓慢漂移，要么间歇性地锚定在左心室乳头肌（PM）上。主频（DF）分析显示，最高局部DF靠近PM（12.5±1.1Hz）。在2型VF期间，这些螺旋波的最高局部DF与突破点（11.8±1.7Hz）以及同时获得的整体伪心电图的DF（11.2±1.8Hz，r = 0.97，P<0.0001）之间存在极好的相关性。我们还通过在模拟的三维组织平板中使用Luo-Rudy动作电位模型，在兴奋性降低和动作电位时程恢复平坦的条件下，成功再现了2型VF的主要特征。
静止或缓慢漂移的母转子均可导致2型VF。静止母转子与PM的共定位表明潜在解剖结构在母转子形成中的重要性。
