イストムス依存性心房の心房活性化
L M Rodriguez1, C Timmermans, A Nabar
1Department of Cardiology, Academic Hospital Maastricht, Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands. LM.Rodriguez@cardio.azm.nl
Circulation
|November 21, 2001
まとめ
静脈依存性心房動 (AFL) では,電気回路は右心房に限られている. 左心房 (LA) は被動的に活性化され,飛躍波の傍観者としての役割を果たします.
科学分野:
- 心臓病学 心臓病学
- 電気生理学 電気生理学
- 心臓の解剖学 心臓の解剖学
背景:
- 静脈関節依存性心房動 (AFL) は,心拍不良の一般的な症状である.
- 心房間接続と左心房 (LA) の活性化を理解することは,AFLの管理に不可欠です.
研究 の 目的:
- イストムス依存型AFLのバイアトリアル活性化パターンを決定する.
- 機能的な心房間接続と心房間接続の活性化パターンを明らかにする.
主な方法:
- エレクトロアナトミックマッピングシステムは,AFLのために右心房静脈切除手術を受けている10人の患者のバイアトリアル活性化に使用されました.
- AFL回路の反時計方向 (n=7) と時計方向 (n=3) の分析. AFL回路の反時計方向 (n=7) と時計方向 (n=3) との分析. AFL回路の反時計方向 (n=3) との分析. AFL回路の反時計方向 (n=3) との分析.
主要な成果:
- AFL回路は,静脈状で,静脈間を通ってゆっくりと (0.5+/-0.2 m/s) 伝播していた.
- 左心房 (LA) は,心房隔膜に突破口を持つ2つの波線によって活性化され,AFLサイクルの50+/-16%を重複させました.
- 逆時計方向のAFLでは,LAの活性化が内側上部で,隔膜の活性化と同期し,静脈から飛ぶ波の出口によって開始された.
結論:
- 筋管依存性AFLの回路は,完全に右心房内にある.
- 左心房 (LA) の活性化は傍観者の現象である.
- LAの活性化は,下側冠動脈シヌス-LA接続,バッハマン・バンドル,および/またはフォサ・オヴァリスを通過するトランス・セプタル伝導を経由して発生します.
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