Center for Arrhythmia Research, University of Michigan, NCRC, 2800 Plymouth Rd, Ann Arbor, MI 48109, USA.
Circ Res. 2013 Mar 1;112(5):849-62. doi: 10.1161/CIRCRESAHA.111.300158.
The objective of this article is to present a broad review of the role of cardiac electric rotors and their accompanying spiral waves in the mechanism of cardiac fibrillation. At the outset, we present a brief historical overview regarding reentry and then discuss the basic concepts and terminologies pertaining to rotors and their initiation. Thereafter, the intrinsic properties of rotors and spiral waves, including phase singularities, wavefront curvature, and dominant frequency maps, are discussed. The implications of rotor dynamics for the spatiotemporal organization of fibrillation, independent of the species being studied, are described next. The knowledge gained regarding the role of cardiac structure in the initiation or maintenance of rotors and the ionic bases of spiral waves in the past 2 decades, as well as the significance for drug therapy, is reviewed subsequently. We conclude by examining recent evidence suggesting that rotors are critical in sustaining both atrial and ventricular fibrillation in the human heart and its implications for treatment with radiofrequency ablation.
本文的目的是对心脏电旋转子及其伴随的螺旋波在心律失常机制中的作用进行广泛综述。首先，我们简要回顾了折返的历史，然后讨论了与旋转子及其引发相关的基本概念和术语。此后，讨论了旋转子和螺旋波的固有特性，包括相位奇点、波阵面曲率和主导频率图。接下来描述了旋转子动力学对心律失常时空组织的影响，而不考虑所研究的物种。接下来回顾了过去 20 年中关于心脏结构在旋转子的引发或维持中的作用以及螺旋波离子基础的知识，以及对药物治疗的意义。最后，我们研究了最近的证据，表明旋转子在维持人心房和心室颤动中至关重要，以及对射频消融治疗的影响。
