人类对双心电合的研究:内心隔膜激活的决定因素和对心脏间连接的导电
Robert Lemery1, Luc Soucie, Bruno Martin
1Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, Ontario, Canada K1Y 4W7. rlemery@ottawaheart.ca
Circulation
|October 7, 2004
概括
在人类中,心房之间的电主要通过巴克曼捆和冠状动脉鼻发生,而不是心房隔膜. 心房隔膜本身显示异步激活,突出显示了心房激活的关键途径.
科学领域:
- 心脏电生理学 心脏电生理学
- 人体生理学 人体生理学
- 耳前功能 耳前功能
背景情况:
- 右心房 (RA) 和左心房 (LA) 之间的电通信对于协调的心脏功能至关重要.
- 了解心房间间的连接是人类心脏电生理学的基础.
- 以前的研究还没有完全阐明不同心房结构对心房激活的具体途径和贡献.
研究的目的:
- 为了研究人体RA和LA之间的电合机制.
- 确定心房隔膜和心房间际连接对心房活化的相对贡献.
主要方法:
- 在导管切除之前,同时对20名患有症状性心房的患者进行了双心房非接触测绘.
- 多电极阵列导管被放置在RA和LA (横向).
- 分析了同电位图,以评估在各种节奏条件 (鼻腔节奏,RA节奏,LA附属节奏,冠状动脉鼻腔节奏) 期间内心隔膜激活和心房间间导通通路.
主要成果:
- 内心隔膜激活的RA和LA通常是单独的,独立的,和异步的.
- 腹腔间导电主要发生在巴克曼捆上,在鼻节奏和高RA/LA附属体节奏期间.
- 通过冠状动脉鼻传导在所有患者中观察到,当从冠状动脉鼻进行节奏时,巴赫曼捆绑也涉及26%的病例.
- 在卵巢上进行的心房间间导电是最小的,仅在2%的分析段中发生.
结论:
- 在RA和LA之间的电气合主要由肌肉连接促进,特别是巴克曼捆和冠状动脉鼻.
- 真正的心房隔膜,包括卵巢和它的四肢,在电力上是异步的,并且在正常的节奏或节奏过程中通常缺乏对侧导电.
- 这些发现澄清了负责人类协调性心房激活的主要途径.
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