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心房颤动、自主神经张力、窦房结与炎症假设界面处心房颤动与窦性心律的相互依存关系:分析性综述、重新思考、推测与新见解

Interdependent Relationship Between Atrial Fibrillation and Sinus Rhythm at the Hypothetical Interface of Atrial Fibrillation, Autonomic Tone, Sinoatrial Node and Inflammation : Analytical Review, Reconsiderations, Speculations and New Insights.

作者信息

Stirbys Petras

机构信息

Department of Cardiology, Hospital of Lithuanian University of Health Sciences , Kaunas Clinics, Kaunas, Lithuania.

出版信息

J Atr Fibrillation. 2012 Dec 16;5(4):613. doi: 10.4022/jafib.613. eCollection 2012 Dec.

Abstract

Underlying mechanisms of atrial fibrillation occurrence and its self-extinguishing remain not completely investigated yet. The role of autonomic tone and sinoatrial node in the interplay between atrial fibrillation and sinus rhythm is also not fully understood. The influence of inflammation as a possible source of arrhythmia and likelihood of its pharmacologic treatment deserves special attention. These complex issues are important for better understanding of arrhythmogenesis and rhythm control. Conceptual reconsiderations through the new insights primarily on the hypothetic basis may delineate new therapeutic and preventive strategies. The aim of this analytical review was to reinforce the clinical and laboratory studies regarding the role of: 1) autonomic tone and sinoatrial node in restitution of sinus rhythm, 2) new concept of ?vibrantly quiescent stroboscopic tuning? as a matured status of atrial fibrillation being prepared for its abruption by slight impulse, 3) inflammation in the interplay between atrial fibrillation and sinus rhythm, 4) anti-inflammation and anti-allergic therapy to prevent and to treat the arrhythmia.

摘要

心房颤动发生及其自行终止的潜在机制尚未得到充分研究。自主神经张力和窦房结在心房颤动与窦性心律相互作用中的作用也尚未完全了解。炎症作为心律失常的一个可能来源的影响及其药物治疗的可能性值得特别关注。这些复杂问题对于更好地理解心律失常的发生机制和节律控制很重要。主要基于假设的新见解进行的概念性重新思考可能会勾勒出新的治疗和预防策略。本分析综述的目的是加强关于以下方面作用的临床和实验室研究:1)自主神经张力和窦房结在窦性心律恢复中的作用;2)“动态静止频闪调谐”这一新概念,作为心房颤动准备因轻微冲动而中断的成熟状态;3)炎症在心房颤动与窦性心律相互作用中的作用;4)抗炎和抗过敏治疗以预防和治疗心律失常。

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