構造的な心疾患の患者における長年にわたる持続的な心房細動の電気病理学的基質:心臓上の突破
Natasja M S de Groot1, Richard P M Houben, Joep L Smeets
1Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands.
Circulation
|October 13, 2010
まとめ
絶え間ない心房細動 (AF) の焦点動波は,細胞メカニズムではなく,表心突破から発生します. これらの突破は,長年のAFの4倍の頻度で,心臓病患者におけるその持続性を説明します.
科学分野:
- 心臓病学 心臓病学
- 電気生理学 電気生理学
- 心臓外科手術について
背景:
- 持続的な心房細動 (AF) は,しばしば焦点活性化波を示します.
- AFの持続性におけるこれらの焦点波の起源と役割は不明である.
研究 の 目的:
- 持続的なAFにおける焦点動波の起源とメカニズムを調査する.
- 構造的な心疾患を有する患者のAF持続に対するこれらの波の関連性を決定する.
主な方法:
- 心臓外科手術中に長期にわたって持続したAFを持つ24人の患者の心房の高密度マッピング.
- ウェーブレットを分離し,焦点起源を特定するためのマッピングアルゴリズムの開発.
- 急性発現したAFを患った25人の患者の基準グループと比較した.
主要な成果:
- 焦点動の波は,急性AFと比較して,持続的なAFではほぼ4倍の頻度 (0.46対0.12/サイクル/cm2) でした.
- これらの波は,細胞メカニズムではなくて,表心突破から発生し,多くの場合,複数の波線フロントを開始しました.
- 突破の発生率は,長年のAFの患者で著しく高かった.
結論:
- 焦点動の波は,より深い心房壁の活性化の先頭葉突破から生じる.
- 長期にわたるAFで表心臓突破の頻度の増加はAFの持続性を十分に説明します.
- これらの突破は,心臓の表面上の動波の独立した源として作用します.
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