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Sus alternancias de electrogramas revelan entradas de doble frente de onda y disociación longitudinal dentro del
Y Zhang1, S Bharati, K A Mowrey
1Department of Cardiology, the Cleveland Clinic Foundation, Cleveland, Ohio, 44195, USA.
Circulation
|August 15, 2001
Resumen
Sus alternantes de electrograma (HE) revelan distintos frentes de onda rápidos y lentos en el nodo atrioventricular (AVN). Esto demuestra la disociación funcional dentro de la AVN, lo que ayuda a comprender las arritmias reentrantes.
Área de la Ciencia:
- Electrofisiología cardiovascular electrofisiología cardiovascular.
- Anatomía y Fisiología Cardíaca.
Sus antecedentes:
- Cambios observados en la amplitud y morfología de su electrograma (HE) durante las transiciones en la conducción nodal atrioventricular (AVN).
- No se entiende bien la importancia de estos cambios de HE para la electrofisiología de doble AVN.
Objetivo del estudio:
- Para investigar el fenómeno de cambiar las características de su electrograma durante los cambios en la conducción AVN.
- Para aclarar el papel de estos cambios en la electrofisiología de doble AVN y su posible vínculo con las arritmias.
Principales métodos:
- Experimentos con preparaciones de AVN auricular de conejo utilizando ritmo eléctrico programado.
- Mapeo de sus electrogramas (HEs) a lo largo de su haz con electrodos de superficie.
- Registro de potenciales de acción celular (PA) para identificar los frentes de onda de excitación.
Principales resultados:
- Los HEs superiores de su paquete disminuyeron en amplitud durante los latidos prematuros, mientras que los HEs inferiores aumentaron significativamente.
- Se observó un cambio temporal en la secuencia de activación HE superior e inferior, correlacionado con los cambios en la velocidad de conducción.
- Las grabaciones celulares confirmaron la presencia de distintos frentes de onda de excitación rápida y lenta asociados con los alternantes HE.
Conclusiones:
- La evidencia sugiere una disociación longitudinal funcional dentro de la unión AV en dos dominios debido a la llegada diferente de frentes de onda rápidos y lentos al paquete His.
- Las alternas HE características sirven como un indicador sensible de distintos frentes de onda y su participación en las arritmias.
- Los hallazgos mejoran la comprensión de los mecanismos subyacentes a la electrofisiología de doble AVN.
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