Waldo A L
Department of Medicine, Case Western Reserve University/University Hospitals of Cleveland, Ohio 44106, USA.
J Cardiovasc Electrophysiol. 1997 Mar;8(3):337-52. doi: 10.1111/j.1540-8167.1997.tb00798.x.
Entrainment was first described based on observations during rapid (overdrive) pacing of type I atrial flutter. Entrainment is capture of the reentrant circuit of a tachycardia without interrupting the tachycardia, so that with cessation of pacing, the spontaneous reentrant tachycardia is still present. During entrainment, the orthodromic wavefront from the pacing impulse resets the tachycardia to the pacing rate, while the antidromic wavefront either collides with the orthodromic wavefront of the previous beat (usual case) or is blocked by some other mechanism (refractoriness or another cause of block). Entrainment may be either manifest or concealed. The principles of entrainment during type I atrial flutter have permitted identification of targets for successful ablation, of mapping sites within or outside the reentrant circuit, and of appropriate pacing rates to successfully interrupt atrial flutter and restore sinus rhythm.
最早基于对I型心房扑动快速（超速）起搏时的观察描述了拖带现象。拖带是指在不中断心动过速的情况下捕获心动过速的折返环，因此在起搏停止后，自发性折返性心动过速仍然存在。在拖带期间，起搏冲动产生的顺向波前将心动过速重置为起搏频率，而逆向波前要么与前一心搏的顺向波前碰撞（通常情况），要么被其他某种机制（不应期或其他阻滞原因）阻滞。拖带可表现为显性或隐匿性。I型心房扑动期间的拖带原理有助于确定成功消融的靶点、折返环内外的标测部位以及成功中断心房扑动并恢复窦性心律的合适起搏频率。
