Egorov Y V, Rozenshtraukh L V
National Medical Research Center for Cardiology.
Institute of Cardiology of Russian Cardiology Scientific and Production Complex.
Kardiologiia. 2018 Jun;58(6):37-43.
Recently, the notion that in 60-80 % of cases the origin of the pulmonary veins (PV) is the place of origin of atrial fibrillation (AF) has become widespread. It has been shown that in this area, under the action of norepinephrine (HA), in the absence of stimulation, an intrinsic rhythm appears. Using two-channel microelectrode leads (from the mouth and distal part of the PV) in rats weighing 350-450 grams, it was found that: 1) in the distal part of PV there are cells with depolarized resting potential (RP) up to -50 mV, which under normal conditions are not excitable; 2) in 17 experiments out of 23, various blocks of excitation conduction along PV were revealed; 3) in 8 experiments out of 23, a reflected excitation wave - echo from PV - was recorded. Myocardium of PV is an extremely heterogeneous medium with a strong variance in the duration of the action potential and variable rate of conduction, which contributes to the occurrence of different types of conduction blocks and causes echoes and other rhythm disturbances.
最近,认为在60%-80%的病例中肺静脉(PV)起源处是心房颤动(AF)起源部位的观点已广为流传。研究表明,在该区域,在去甲肾上腺素(HA)作用下,无刺激时会出现固有节律。使用双通道微电极导联(从PV的口部和远端)对体重350-450克的大鼠进行研究,发现:1)在PV远端存在静息电位(RP)去极化至-50 mV的细胞,在正常情况下这些细胞不可兴奋;2)在23个实验中的17个实验中,发现沿PV存在各种兴奋传导阻滞;3)在23个实验中的8个实验中,记录到来自PV的反射兴奋波——回波。PV心肌是一种极其不均一的介质,动作电位持续时间差异很大,传导速度可变,这有助于不同类型传导阻滞的发生,并导致回波及其他节律紊乱。