Clancy E A, Smith J M, Cohen R J
Massachusetts Institute of Technology Department of Electrical Engineering and Computer Science, Cambridge 02139.
IEEE Trans Biomed Eng. 1991 Jun;38(6):551-60. doi: 10.1109/10.81580.
Recent evidence has shown that a subtle alternation in the surface ECG (electrical alternans) may be correlated with the susceptibility to ventricular fibrillation. This paper presents evidence that a mechanical alternation in the heart beat (mechanical alternans) generally accompanies electrical alternans. A simple finite-element computer model, which emulates both the electrical and mechanical activity of the heart, is presented. A pilot animal study is also reported. The computer model and the animal study both found that 1) there exists a regime of combined electrical-mechanical alternans during the transition from a normal rhythm towards a fibrillatory rhythm, 2) the detected degree of alternation is correlated with the relative instability of the rhythm, and 3) the electrical and mechanical alternans may result from a dispersion in local electrical properties leading to a spatial-temporal alternation in the electrical conduction process.
最近的证据表明，体表心电图的细微变化（电交替）可能与心室颤动的易感性相关。本文提供的证据表明，心跳的机械变化（机械交替）通常与电交替同时出现。本文提出了一个简单的有限元计算机模型，该模型模拟了心脏的电活动和机械活动。还报告了一项初步动物研究。计算机模型和动物研究均发现：1）在从正常节律向颤动节律转变的过程中，存在电-机械交替组合的状态；2）检测到的交替程度与节律的相对不稳定性相关；3）电交替和机械交替可能是由于局部电特性的离散导致电传导过程中的时空交替所致。
