Allessie M A, Kirchhof C J, Konings K T
Department of Physiology, University of Limburg, Maastricht, The Netherlands.
Eur Heart J. 1996 Jul;17 Suppl C:2-9. doi: 10.1093/eurheartj/17.suppl_c.2.
Animal experiments have confirmed that a short but variable excitable gap is present during induced atrial fibrillation. The existence of this gap allows atrial fibrillation to be locally captured by rapid pacing. An area of up to 4 cm in diameter can be activated by uniform wave fronts propagating away from the site of stimulation, although the size of this area may be limited by intra-atrial conduction block or by collision with fibrillation waves. Rapid pacing can accelerate atrial fibrillation by inducing local re-entry circuits with a cycle length shorter than the pacing interval. During pacing-induced atrial fibrillation in patients undergoing surgery for Wolff-Parkinson-White syndrome, three types of atrial activation have been identified, which vary in their degree of complexity and in the length of their fibrillation intervals. It appears that the spectrum of varying cycle lengths during atrial fibrillation might be explained by a mixture of different sorts of atrial re-entry patterns, comprising purely functional intra-atrial re-entry, random re-entry, anatomical re-entry, and nodal re-entry.
动物实验已证实，在诱发性心房颤动期间存在短暂但可变的易激间隙。这一间隙的存在使得心房颤动能够被快速起搏局部捕获。尽管该区域的大小可能受心房内传导阻滞或与颤动波碰撞的限制，但直径达4厘米的区域可被从刺激部位传播开来的均匀波阵面激活。快速起搏可通过诱导周期长度短于起搏间期的局部折返环路来加速心房颤动。在接受 Wolff-Parkinson-White 综合征手术的患者中，在起搏诱发的心房颤动期间已识别出三种类型的心房激动，它们在复杂程度和颤动间期长度方面各不相同。心房颤动期间不同周期长度的频谱似乎可以用不同类型的心房折返模式的混合来解释，这些模式包括纯功能性心房内折返、随机折返、解剖学折返和结性折返。
