Chen P S, Garfinkel A, Weiss J N, Karagueuzian H S
Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
Pacing Clin Electrophysiol. 1997 Feb;20(2 Pt 2):414-21. doi: 10.1111/j.1540-8159.1997.tb06200.x.
The chaos theory is based on the idea that phenomena that appear disordered and random may actually be produced by relatively simple deterministic mechanisms. The disordered (aperiodic) activation that characterizes a chaotic motion is reached through one of a few well-defined paths that are characteristic of nonlinear dynamical systems. Our group has been studying VF using computerized mapping techniques. We found that in electrically induced VF, reentrant wavefronts (spiral waves) are present both in the initial tachysystolic stage (resembling VT) and the later tremulous incoordination stage (true VF). The electrophysiological characteristics associated with the transition from VT to VF is compatible with the quasiperiodic route to chaos as described in the Ruelle-Takens theorem. We propose that specific restitution of action potential duration (APD) and conduction velocity properties can cause a spiral wave (the primary oscillator) to develop additional oscillatory modes that lead to spiral meander and breakup. When spiral waves begin to meander and are modulated by other oscillatory processes, the periodic activity is replaced by unstable quasiperiodic oscillation, which then undergoes transition to chaos, signaling the onset of VF. We conclude that VF is a form of deterministic chaos. The development of VF is compatible with quasiperiodic transition to chaos. These results indicate that both the prediction and the control of fibrillation are possible based on the chaos theory and with the advent of chaos control algorithms.
混沌理论基于这样一种观点，即看似无序和随机的现象实际上可能由相对简单的确定性机制产生。表征混沌运动的无序（非周期性）激活是通过非线性动力系统特有的少数几条明确路径之一实现的。我们小组一直在使用计算机映射技术研究室颤。我们发现，在电诱导的室颤中，折返波前（螺旋波）在初始快速收缩期（类似于室速）和后期颤动不协调期（真正的室颤）均存在。与从室速转变为室颤相关的电生理特征与鲁埃尔 - 塔肯斯定理中描述的通向混沌的准周期路径相符。我们提出，动作电位时程（APD）和传导速度特性的特定恢复可以使螺旋波（主要振荡器）产生额外的振荡模式，从而导致螺旋曲折和破裂。当螺旋波开始曲折并受到其他振荡过程的调制时，周期性活动被不稳定的准周期振荡所取代，然后转变为混沌，这标志着室颤的开始。我们得出结论，室颤是一种确定性混沌形式。室颤的发展与向混沌的准周期转变相符。这些结果表明，基于混沌理论以及随着混沌控制算法的出现，颤动的预测和控制都是可能的。
