Fedorov Vadim V., Trifonova Oksana P., Glukhov Alex V., Rosen Michael R., Rosenshtraukh. Leonid V.
Laboratory of Heart Electrophysiology, Cardiology Research Center, 3rd Cherepkovskaya 15a, 121552 Moscow, Russia
Center for Molecular Therapeutics Columbia University, 630 West 168 Street, PH 7W-321, New York, NY, 10032, USA
Atrial fibrillation (AF) initiation may be due to both abnormal focal activity and to reentry. AF frequently occurs under conditions associated with atrial dilatation (stretch) or vagal hyperactivity. Atrial stretch may contribute to focal arrhythmias by inducing afterdepolarizations and to reentrant arrhythmias by increasing the atrial surface, by shortening the refractory period and/or slowing the conduction velocity and by increasing spatial dispersion. Moreover vagal stimulation contributes to the maintenance of AF by decreasing the atrial refractory periods and increasing the inhomogeneity of refractoriness in the atria. Here we review recent findings showing that mechano-electrical feedback (MEF) may create a substrate for spontaneous initiation of vagal AF. We proposed that conduction slowing during acute atrial stretch may play a role in the genesis of cholinergic AF.
心房颤动（AF）的起始可能归因于异常的局灶性活动和折返。AF常发生于与心房扩张（牵张）或迷走神经功能亢进相关的情况下。心房牵张可能通过诱发后除极促进局灶性心律失常，并通过增加心房表面积、缩短不应期和/或减慢传导速度以及增加空间离散度促进折返性心律失常。此外，迷走神经刺激通过缩短心房不应期和增加心房不应期的不均一性促进AF的维持。在此，我们综述了最近的研究结果，这些结果表明机械电反馈（MEF）可能为迷走神经介导的AF的自发起始创造一个基质。我们提出，急性心房牵张期间的传导减慢可能在胆碱能性AF的发生中起作用。
