Smith J M, Cohen R J
Proc Natl Acad Sci U S A. 1984 Jan;81(1):233-7. doi: 10.1073/pnas.81.1.233.
A simple finite-element model of ventricular conduction processes that explicitly incorporates spatial dispersion of refractoriness was developed. This model revealed that spatial dispersion of refractoriness is a sufficient condition to produce self-sustained reentry even in the absence of unidirectional block, inhomogeneity in local conduction velocities, or the presence of ectopic pacemakers. The model displayed a wide variety of rhythm disturbances qualitatively similar to clinically familiar cardiac dysrhythmias. Electrical stability of the model was determined as a function of the model parameters including ventricular stimulation rate, conduction velocity, and mean refractory period as well as standard deviation of refractory periods. We conclude that spatial dispersion of refractoriness is a sufficient condition to initiate reentrant dysrhythmias but that other physiologic variables such as ventricular rate and conduction velocity strongly influence the dysrhythmogenic effect of spatial dispersion of refractoriness.
开发了一个简单的心室传导过程有限元模型,该模型明确纳入了不应期的空间离散。该模型显示,即使在没有单向阻滞、局部传导速度不均匀或存在异位起搏器的情况下,不应期的空间离散也是产生自我持续折返的充分条件。该模型展示了多种节律紊乱,在性质上与临床常见的心脏心律失常相似。模型的电稳定性是根据包括心室刺激率、传导速度、平均不应期以及不应期标准差在内的模型参数来确定的。我们得出结论,不应期的空间离散是引发折返性心律失常的充分条件,但其他生理变量,如心室率和传导速度,强烈影响不应期空间离散的致心律失常效应。