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为何消融浦肯野纤维激动部位具有抗心律失常作用：快速激动与心律失常发生之间的相互作用。

Why Ablation of Sites With Purkinje Activation Is Antiarrhythmic: The Interplay Between Fast Activation and Arrhythmogenesis.

作者信息

Coronel Ruben, Potse Mark, Haïssaguerre Michel, Derval Nicolas, Rivaud Mathilde R, Meijborg Veronique M F, Cluitmans Matthijs, Hocini Mélèze, Boukens Bastiaan J

机构信息

Department of Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.

IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Bordeaux, France.

出版信息

Front Physiol. 2021 Mar 23;12:648396. doi: 10.3389/fphys.2021.648396. eCollection 2021.

DOI:10.3389/fphys.2021.648396
PMID:33833689
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8021688/
Abstract

Ablation of sites showing Purkinje activity is antiarrhythmic in some patients with idiopathic ventricular fibrillation (iVF). The mechanism for the therapeutic success of ablation is not fully understood. We propose that deeper penetrance of the Purkinje network allows faster activation of the ventricles and is proarrhythmic in the presence of steep repolarization gradients. Reduction of Purkinje penetrance, or its indirect reducing effect on apparent propagation velocity may be a therapeutic target in patients with iVF.

摘要

在一些特发性室颤（iVF）患者中，消融显示浦肯野纤维活动的部位具有抗心律失常作用。消融治疗成功的机制尚未完全明确。我们提出，浦肯野纤维网络更深的穿透性可使心室更快激活，并且在存在陡峭复极梯度的情况下具有促心律失常作用。降低浦肯野纤维穿透性或其对表观传播速度的间接降低作用可能是iVF患者的一个治疗靶点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f298/8021688/2075aa5906cb/fphys-12-648396-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f298/8021688/10eff3a1b0c2/fphys-12-648396-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f298/8021688/2075aa5906cb/fphys-12-648396-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f298/8021688/10eff3a1b0c2/fphys-12-648396-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f298/8021688/2075aa5906cb/fphys-12-648396-g002.jpg

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Critical repolarization gradients determine the induction of reentry-based torsades de pointes arrhythmia in models of long QT syndrome.临界复极梯度决定长 QT 综合征模型中折返性尖端扭转型室性心动过速的诱发。
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Idiopathic Ventricular Fibrillation: Role of Purkinje System and Microstructural Myocardial Abnormalities.
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