Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia; Cardiac Arrhythmia Center, University of California, Los Angeles (UCLA), 100 UCLA Medical Plaza, Suite 660, Los Angeles, CA 90095, USA.
Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands.
Card Electrophysiol Clin. 2024 Sep;16(3):271-280. doi: 10.1016/j.ccep.2023.08.003. Epub 2023 Sep 19.
Several complex mechanisms, working alone, or together, initiate and maintain atrial fibrillation (AF). At disease onset, pulmonary vein-atrial triggers, producing ectopy, predominate. Then, as AF progresses, a shift toward substrate occurs, which AF also self-perpetuates. The autonomic nervous system (ANS) plays an important role as trigger and substrate. Although the efferent arm of the ANS as AF trigger is well-established, there is emerging evidence to show that (1) the ANS is a substrate for AF and (2) afferent or regulatory ANS dysfunction occurs in AF patients. These findings could represent a mechanism for the progression of AF.
几种复杂的机制单独或共同作用，引发并维持心房颤动（房颤）。在疾病发作时，肺静脉-心房触发产生异位搏动占主导地位。然后，随着房颤的进展，会出现向基质的转变，而房颤也会自我维持。自主神经系统（ANS）作为触发因素和基质起着重要作用。尽管 ANS 的传出神经臂作为房颤触发因素已得到充分证实，但有新的证据表明：（1）ANS 是房颤的基质；（2）房颤患者存在传入或调节性 ANS 功能障碍。这些发现可能代表了房颤进展的一种机制。
