Yi Dong, Li Lei, Han Min, Qiu Rujie, Tao Liang, Liu Li, Liu Chengwei
Division of Cardiac Care Unit, Department of Cardiology, Wuhan Asia Heart Hospital, Wuhan, Hubei, China.
Department of Cardiac Surgery, Wuhan Asia Heart Hospital, Wuhan, Hubei, China.
Front Cardiovasc Med. 2023 Jan 25;10:1100425. doi: 10.3389/fcvm.2023.1100425. eCollection 2023.
Atrial fibrillation (AF) is one of the most common arrhythmias encountered in clinical practice. The pathophysiological mechanisms responsible for its development are complex, vary amongst individuals, and associated with predisposing factors. Here, we report a case of AF caused by annular constrictive pericarditis (ACP), which is extremely rare due to its unusual anatomical form. In our patient, AF was refractory to multiple antiarrhythmic medications; however, spontaneous conversion to sinus rhythm occurred when the ring encircling the right and left ventricular (RV and LV) cavities along the atrioventricular (AV) groove was severed. This suggests that atrial stretch due to atrial enlargement and increased left atrial (LA) pressure may contribute to the initiation and maintenance of AF. This report highlights the importance of the careful investigation of rare predisposing factors for AF using non-invasive diagnostic approaches and mechanical-electric feedback (MEF) as a pathophysiological mechanism for AF initiation and maintenance.
心房颤动（AF）是临床实践中最常见的心律失常之一。其发生的病理生理机制复杂，因人而异，且与易感因素相关。在此，我们报告一例由环形缩窄性心包炎（ACP）引起的AF病例，因其特殊的解剖形式而极为罕见。在我们的患者中，AF对多种抗心律失常药物均无效；然而，当沿着房室（AV）沟环绕右心室和左心室（RV和LV）腔的环被切断时，自发转为窦性心律。这表明心房扩大和左心房（LA）压力增加导致的心房牵张可能有助于AF的起始和维持。本报告强调了使用非侵入性诊断方法仔细调查AF罕见易感因素以及机械-电反馈（MEF）作为AF起始和维持的病理生理机制的重要性。
