Latcu Gabriel Decebal, Meste Olivier, Duparc Alexandre, Mondoly Pierre, Rollin Anne, Delay Marc, Maury Philippe
Centre Hospitalier Princesse Grace, Monaco Cedex, Monaco.
J Interv Card Electrophysiol. 2011 Apr;30(3):199-209. doi: 10.1007/s10840-010-9541-1. Epub 2011 Jan 27.
Analysing ventricular fibrillation (VF) rate and regularity at different sites and at different times may help understanding some of the mechanisms underlying VF in humans.
Twelve episodes of VF (19.4 ± 5.6 s) were induced during electrophysiological study in eight men (63 ± 14 years old). Calculation of dominant frequency (DF) by fast Fourier transform, short-time Fourier transform, and analysis of the pitch frequency [VF cycle length duration (CL)] were performed. For each episode, we analysed the 12 lead-surface ECG, three unipolar, 10 near-field, and three far-field bipolar recordings by means of three quadripolar catheters positioned at the right ventricular apex (RV apex), right ventricular outflow tract, and at the coronary sinus (exploring the lateral left ventricular epicardium) (LV).
Fast and regular discrete activation covered the whole duration of every intracardiac recording, whereas surface ECG consistently displayed chaotic and fibrillatory pattern. DF (5.25 ± 0.64 Hz) was very similar on surface ECG recordings and in various intracardiac recordings. Intracardiac activation was rather regular during VF despite the fibrillatory process with very low SD of the CL. There were some significant inverse correlations between VF rate and VF regularity. Intracardiac sites displaying the fastest and most regular activations were those including the RV apex. VF rate and stability slightly increased over time. Finally, the parameters exploring the VF rate were found to be well correlated together, as well as parameters of VF regularity
Human VF induced during electrophysiological study has a clear DF of activation and appears quite regular in intracardiac recordings. There is some spatial heterogeneity, which needs to be more detailed in order to localize possible driving sources. Fastest VF are the most regular. Rate and stability tend to increase during the initial phases of VF.
分析不同部位和不同时间的心室颤动（VF）频率及规律性，可能有助于理解人类VF的一些潜在机制。
在8名男性（63±14岁）的电生理研究中诱发了12次VF发作（19.4±5.6秒）。通过快速傅里叶变换、短时傅里叶变换计算主导频率（DF），并分析基音频率[VF周期长度持续时间（CL）]。对于每次发作，我们通过置于右心室心尖（RV心尖）、右心室流出道和冠状窦（探索左心室外侧心外膜）（LV）的三根四极导管，分析了12导联体表心电图、三个单极、10个近场和三个远场双极记录。
快速且规则的离散激活覆盖了每次心内记录的整个持续时间，而体表心电图始终显示出混乱的颤动模式。DF（5.25±0.64Hz）在体表心电图记录和各种心内记录中非常相似。尽管存在颤动过程且CL的标准差很低，但VF期间的心内激活相当规则。VF频率与VF规律性之间存在一些显著的负相关。显示最快和最规则激活的心内部位是包括RV心尖的部位。VF频率和稳定性随时间略有增加。最后，发现探索VF频率的参数之间以及VF规律性参数之间具有良好的相关性。
电生理研究中诱发的人类VF具有明确的激活DF，在心内记录中显得相当规则。存在一些空间异质性，需要更详细地研究以定位可能的驱动源。最快的VF最规则。VF的频率和稳定性在VF的初始阶段趋于增加。
