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心房颤动的机制:转子、离子决定因素和兴奋频率。

Mechanisms of atrial fibrillation: rotors, ionic determinants, and excitation frequency.

作者信息

Berenfeld Omer, Jalife José

机构信息

Center for Arrhythmia Research, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI 48109, USA.

Center for Arrhythmia Research, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI 48109, USA.

出版信息

Cardiol Clin. 2014 Nov;32(4):495-506. doi: 10.1016/j.ccl.2014.07.001. Epub 2014 Oct 23.

DOI:10.1016/j.ccl.2014.07.001
PMID:25443232
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4254447/
Abstract

Atrial fibrillation (AF) is the most common cardiac arrhythmia; however, therapy is suboptimal. We review recent data on dynamics of wave propagation during AF and its mechanistic link to the substrate. Data show that the dominant frequency (DF) increase during transition to persistent AF may be explained by rotor acceleration. We discuss how translation of experimentally derived understanding of the rotors may find its way into the clinic, focusing on studies analyzing spatial distribution of DF in the atria of patients with paroxysmal versus persistent AF, and how that knowledge might contribute to improve the outcome of AF ablation procedures.

摘要

心房颤动(AF)是最常见的心律失常;然而,治疗效果并不理想。我们回顾了关于房颤期间波传播动力学及其与基质的机制联系的最新数据。数据表明,向持续性房颤转变过程中主导频率(DF)的增加可能由转子加速来解释。我们讨论了如何将从实验得出的对转子的理解转化应用于临床,重点关注分析阵发性与持续性房颤患者心房中DF空间分布的研究,以及这些知识如何有助于改善房颤消融手术的结果。

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本文引用的文献

1
Body surface localization of left and right atrial high-frequency rotors in atrial fibrillation patients: a clinical-computational study.心房颤动患者左、右心房高频转子的体表定位:一项临床计算研究。
Heart Rhythm. 2014 Sep;11(9):1584-91. doi: 10.1016/j.hrthm.2014.05.013. Epub 2014 May 17.
2
Attraction of rotors to the pulmonary veins in paroxysmal atrial fibrillation: a modeling study.阵发性心房颤动中转子对肺静脉的吸引:一项建模研究。
Biophys J. 2014 Apr 15;106(8):1811-21. doi: 10.1016/j.bpj.2014.02.030.
3
Ablation of rotor and focal sources reduces late recurrence of atrial fibrillation compared with trigger ablation alone: extended follow-up of the CONFIRM trial (Conventional Ablation for Atrial Fibrillation With or Without Focal Impulse and Rotor Modulation).
小电导钙激活钾通道的激活抑制心房肌细胞中的电交替和钙交替。
Int J Mol Sci. 2025 Apr 11;26(8):3597. doi: 10.3390/ijms26083597.
4
Human Atrial Fibrillation Drivers Resolved With Integrated Functional and Structural Imaging to Benefit Clinical Mapping.整合功能和结构影像学以解决人类心房颤动驱动因素,有利于临床绘图。
JACC Clin Electrophysiol. 2018 Dec;4(12):1501-1515. doi: 10.1016/j.jacep.2018.08.024. Epub 2018 Nov 1.
5
Calcium in the Pathophysiology of Atrial Fibrillation and Heart Failure.钙在心房颤动和心力衰竭病理生理学中的作用
Front Physiol. 2018 Oct 4;9:1380. doi: 10.3389/fphys.2018.01380. eCollection 2018.
6
Hyperthyroidism, but not hypertension, impairs PITX2 expression leading to Wnt-microRNA-ion channel remodeling.甲状腺功能亢进而非高血压会损害PITX2表达,导致Wnt-微小RNA-离子通道重塑。
PLoS One. 2017 Dec 1;12(12):e0188473. doi: 10.1371/journal.pone.0188473. eCollection 2017.
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Sci Rep. 2017 Jul 13;7(1):5268. doi: 10.1038/s41598-017-05652-y.
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