Jurkovicová O, Cagán S
Interná klinika, Katedra klinických disciplín pre odbor stomatológie Lekárskej fakulty Univerzity Komenského, Bratislava.
Vnitr Lek. 1991 Apr;37(4):390-6.
The authors give an account of recent findings on the modulating action of the autonomous nervous system on electrophysiological properties of the heart and on mechanisms by which the vegetative nervous system participates in the development of disorders of the cardiac rhythm. In the development of arrhythmias, in particular the importance of the sympathetic nerve is emphasized. The relationship of stimulation of the sympathetic nerve and the development of arrhythmias may be conditioned: by its great activity, uneven distribution of sympathetic innervation and abnormal reaction of the damaged tissue to stimulation of the sympathetic nerve. Mechanisms by which stimulation of the sympathetic nerve may participate in the development of arrhythmias can be summarized as follows: the sympathetic nerve promotes the automation of natural and ectopic centres, shortens the refractory period of the conduction system, of the atrial and ventricular myocardium, increases the vulnerability of the atria and ventricles, reduces the fibrillation threshold; by induction of subsequent depolarizations it may induce (triggered activity); in the depolarized heart muscle it supports the development of slow forms of impulses and thus helps the development of reentry tachycardias; activation of the sympathetic nerve may cause hypokalaemia which is also an arrhythmogenic factor.
作者阐述了自主神经系统对心脏电生理特性的调节作用以及自主神经系统参与心律失常发生机制的近期研究结果。在心律失常的发生过程中，特别强调了交感神经的重要性。交感神经刺激与心律失常发生之间的关系可能取决于：其高度的活性、交感神经支配的不均匀分布以及受损组织对交感神经刺激的异常反应。交感神经刺激可能参与心律失常发生的机制可总结如下：交感神经促进正常和异位起搏点的自律性，缩短传导系统、心房和心室心肌的不应期，增加心房和心室的易损性，降低颤动阈值；通过诱导后续去极化，它可能诱发（触发活动）；在去极化的心肌中，它支持缓慢形式冲动的发展，从而有助于折返性心动过速的发生；交感神经的激活可能导致低钾血症，这也是一个致心律失常因素。
