Flegel K M
Division of General Internal Medicine, Royal Victoria Hospital, Montreal, Quebec, Canada.
Ann Intern Med. 1995 Jun 1;122(11):867-73. doi: 10.7326/0003-4819-122-11-199506010-00010.
In 1874, the electrical stimulation of animal hearts made known the existence of atrial fibrillation, but atrial fibrillation was not associated with its clinical counterpart, arrhythmia perpetua, until 1909, by which time simultaneous recordings of the human heartbeat, the venous and arterial pulses, and electrocardiographic activity had revealed the common origin of these events. After the electrical basis of atrial fibrillation was found and after atrial fibrillation was clearly distinguished from ventricular fibrillation, investigation into its mechanism ensued. Two contrasting theories, that of circus movement and that of tachysystole from a single focus, led to 30 years of research and debate. Pivotal to the argument was the notion of blocked conduction. Although the theory of circus movement prevailed for a long time, it appeared to be demolished by electrophysiologic experiments done between 1948 and 1950. The realization that blocked conduction could later reenter led to more recent research in animals and humans that revived the notion of circular conduction, although in a much more sophisticated form.
1874年，对动物心脏的电刺激使心房颤动被人们所知，但直到1909年，心房颤动才与临床对应病症——永久性心律失常联系起来，那时同步记录人体心跳、静脉和动脉脉搏以及心电图活动揭示了这些现象的共同起源。在发现心房颤动的电生理基础并将其与心室颤动明确区分后，对其机制的研究随即展开。两种截然不同的理论，即环形运动理论和单一病灶快速收缩理论，引发了长达30年的研究和争论。争论的关键在于传导阻滞的概念。尽管环形运动理论长期占主导地位，但在1948年至1950年间进行的电生理实验似乎将其推翻。意识到传导阻滞后来可能重新进入，引发了近期在动物和人体上的研究，使环形传导的概念得以复兴，尽管形式更为复杂。
