Kim Y H, Garfinkel A, Ikeda T, Wu T J, Athill C A, Weiss J N, Karagueuzian H S, Chen P S
Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA.
J Clin Invest. 1997 Nov 15;100(10):2486-500. doi: 10.1172/JCI119791.
We have presented evidence that ventricular fibrillation is deterministic chaos arising from quasiperiodicity. The purpose of this study was to determine whether the transition from chaos (ventricular fibrillation, VF) to periodicity (ventricular tachycardia) through quasiperiodicity could be produced by the progressive reduction of tissue mass. In isolated and perfused swine right ventricular free wall, recording of single cell transmembrane potentials and simultaneous mapping (477 bipolar electrodes, 1.6 mm resolution) were performed. The tissue mass was then progressively reduced by sequential cutting. All isolated tissues fibrillated spontaneously. The critical mass to sustain VF was 19.9 +/- 4.2 g. As tissue mass was decreased, the number of wave fronts decreased, the life-span of reentrant wave fronts increased, and the cycle length, the diastolic interval, and the duration of action potential lengthened. There was a parallel decrease in the dynamical complexity of VF as measured by Kolmogorov entropy and Poincaré plots. A period of quasiperiodicity became more evident before the conversion from VF (chaos) to a more regular arrhythmia (periodicity). In conclusion, a decrease in the number of wave fronts in ventricular fibrillation by tissue mass reduction causes a transition from chaotic to periodic dynamics via the quasiperiodic route.
我们已经提出证据表明室颤是由准周期性产生的确定性混沌。本研究的目的是确定通过逐步减少组织质量，是否能产生从混沌（室颤，VF）经准周期性向周期性（室性心动过速）的转变。在离体灌注的猪右心室游离壁上，进行单细胞跨膜电位记录和同步标测（477个双极电极，分辨率1.6毫米）。然后通过顺序切割逐步减少组织质量。所有离体组织均自发发生颤动。维持室颤的临界质量为19.9±4.2克。随着组织质量减少，波阵面数量减少，折返波阵面的寿命延长，周期长度、舒张期间期和动作电位持续时间延长。通过柯尔莫哥洛夫熵和庞加莱图测量，室颤的动力学复杂性呈平行下降。在从室颤（混沌）转变为更规则的心律失常（周期性）之前，准周期性阶段变得更加明显。总之，通过减少组织质量降低室颤中的波阵面数量，会经由准周期性途径导致从混沌动力学向周期性动力学的转变。
