下回路の再侵入による右心房の振動:メカニズムと解剖学的基板
J Cheng1, W R Cabeen, M M Scheinman
1Section of Cardiac Electrophysiology, University of California San Francisco, CA, USA.
Circulation
|April 6, 1999
まとめ
新しく特定された心房振動 (AFL) のサブタイプ,下回路再入場 (LLR) は,右下心房を巻き込み,三輪-エウスタキア脊間関節に依存しています. この急激なAFLは,この重要な経路の切除によって成功裏に終了されました.
科学分野:
- 心臓病学 心臓病学
- 電気生理学 電気生理学
- 心律不整症とは,心律不整症のこと.
背景:
- 典型的なAFLと異なる急速かつ不規則な心房 (AFL) のメカニズムは不明である.
- これらのメカニズムを理解することは,効果的な心律乱症管理に不可欠です.
研究 の 目的:
- 独特で急速な心房振動のメカニズムを調査する.
- このAFLサブタイプの解剖学的基板と電気生理学的特性を特定するために.
主な方法:
- AFLを患った29人の患者で,マルチエレクトロドカテーテルを用いた電気生理学的記録.
- トリキュピッドアヌルス-ユースタキウス脊間関節に届くアトリヤ外刺激.
- トリキュピッドアヌルス-ユースタキウス脊間関節を標的とした線形切除.
主要な成果:
- 新しいAFLサブタイプ,下回路再侵入 (Lower-loop reentry, LLR) が特定され,右下心房が関与している.
- LLRは,典型的なAFL (217±32 ms vs. 272±40 ms) よりも短いサイクルの長さを実証しました.
- トリキュピッド・アヌルス・ユースタキウス・リッジ・イストムスの双方向ブロックにより,自発的なLLRが終了し,誘導が防止されました.
結論:
- Lower-loop reentry (LLR) は,右心房振動の独特のサブタイプである.
- LLRは,三円 - ユースタキウス脊間峡を通過する伝導に決定的に依存しています.
- この間隔をアブレーションで標的にすることは,LLRの管理に有効です.
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