Rogers J M, Walcott G P, Gladden J D, Melnick S B, Ideker R E, Kay M W
Department of Biomedical Engineering, University of Alabama at Birmingham, 1670 University Blvd., Volker Hall B140, Birmingham, AL 35294, USA.
New J Phys. 2008 Jan 31;10(1):015004. doi: 10.1088/1367-2630/10/1/015004.
It has been proposed that VF waves emanate from stable localized sources, often called "mother rotors." However, evidence for the existence of these rotors is conflicting. Using a new panoramic optical mapping system that can image nearly the entire ventricular epicardium, we recently excluded epicardial mother rotors as the drivers of Wiggers' stage II VF in the isolated swine heart. Furthermore, we were unable to find evidence that VF requires sustained intramural sources. The present study was designed to test the following hypotheses: 1. VF is driven by a specific region, and 2. Rotors that are long-lived, though not necessarily permanent, are the primary generators of VF wavefronts. Using panoramic optical mapping, we mapped VF wavefronts from 6 isolated swine hearts. Wavefronts were tracked to characterize their activation pathways and to locate their originating sources. We found that the wavefronts that participate in epicardial reentry were not confined to a compact region; rather they activated the entire epicardial surface. New wavefronts feeding into the epicardial activation pattern were generated over the majority of the epicardium and almost all of them were associated with rotors or repetitive breakthrough patterns that lasted for less than 2 s. These findings indicate that epicardial wavefronts in this model are generated by many transitory epicardial sources distributed over the entire surface of the heart.
有人提出室颤波源自稳定的局部源,通常称为“母转子”。然而,这些转子存在的证据相互矛盾。我们使用一种新的全景光学标测系统,该系统能够对几乎整个心室心外膜进行成像,最近我们排除了心外膜母转子是离体猪心脏中维格斯氏二期室颤驱动因素的可能性。此外,我们未能找到证据表明室颤需要持续的壁内源。本研究旨在检验以下假设:1. 室颤由特定区域驱动;2. 寿命长但不一定永久的转子是室颤波前的主要发生器。我们使用全景光学标测技术,对6个离体猪心脏的室颤波前进行了标测。追踪波前以表征其激活途径并确定其起源。我们发现,参与心外膜折返的波前并不局限于一个紧凑区域;相反,它们激活了整个心外膜表面。进入心外膜激活模式的新波前在大部分心外膜上产生,并且几乎所有这些波前都与持续时间小于2秒的转子或重复突破模式相关。这些发现表明,该模型中的心外膜波前是由分布在心脏整个表面的许多短暂心外膜源产生的。