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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

Heart Fail Clin. 2016 Apr;12(2):167-78. doi: 10.1016/j.hfc.2015.08.014.

DOI:10.1016/j.hfc.2015.08.014
PMID:26968663
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5547895/
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。我们回顾了近期关于房颤期间波传播动力学及其与基质的机制联系的数据。数据表明,在转变为持续性房颤期间主导频率(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中获得的关于转子的认识转化应用于临床,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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06f4/5547895/e4471d1bca66/nihms888306f7.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06f4/5547895/c245ce66e88c/nihms888306f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06f4/5547895/1dd1ec946950/nihms888306f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06f4/5547895/c2097e7dc46c/nihms888306f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06f4/5547895/e4471d1bca66/nihms888306f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06f4/5547895/3a7181ef9bf5/nihms888306f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06f4/5547895/f524706241d6/nihms888306f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06f4/5547895/3e368855c1e1/nihms888306f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06f4/5547895/c245ce66e88c/nihms888306f4.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06f4/5547895/e4471d1bca66/nihms888306f7.jpg

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本文引用的文献

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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).
消融疗法治疗持续性心房颤动。
Curr Cardiol Rev. 2022;18(2):e290721195115. doi: 10.2174/1573403X17666210729101752.
消融转子和灶区源可降低房颤的晚期复发率,优于单纯触发灶消融:CONFIRM 试验(有或无灶区冲动和转子调制的常规消融治疗房颤)的延长随访结果。
J Am Coll Cardiol. 2014 May 6;63(17):1761-8. doi: 10.1016/j.jacc.2014.02.543. Epub 2014 Mar 13.
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