双波再进入作为加速腹腔动心的加速机制
J Brugada1, L Boersma, C Kirchhof
1Department of Physiology, University of Limburg, Maastricht, The Netherlands.
Circulation
|May 1, 1990
概括
在子心脏中诱导和研究了持续的腹腔动脉短心. 双波再入,即两个波同时循环的现象,被确定为高心率加速的原因,并对药物效应产生影响.
科学领域:
- 心血管生理学心血管生理学
- 电子生理学 电子生理学
- 心脏节律失常症 心脏节律失常症
背景情况:
- 腹腔动脉短拍 (VT) 是一种危及生命的心律失常.
- 了解VT的机制,特别是回流回路,对于开发有效的治疗方法至关重要.
- 心肌无极性,电气性质的方向依赖,影响回入波的传播.
研究的目的:
- 在一个体外模型中研究持续复发性心室低心率的机制.
- 探索双波再入现象及其在心动减速加速中的作用.
- 评估抗节律障碍药物对双波再进入诱导的影响.
主要方法:
- 在使用编程电刺激的Langendorff透的子心室内膜环中诱导持续的腹腔心动.
- 使用256个单极电图进行连续表心映射,以分析回流电路动力学.
- 评估波传播速度 (纵向与横向) 与心肌纤维方向的关系.
- 评估双波再进入诱导及其通过III类和IC类抗节律药物的调制.
主要成果:
- 持续的复进静脉瘤治疗可靠地诱导,周期长度为168±13毫秒.
- 慢心是基于一个围绕固定障碍物的回流电路,具有异型传播 (横向缓慢,纵向快速).
- 在6/26实验中观察到双波再入,导致心动减速加速.
- 在一个案例中,双波再入被III类药物抑制,在另一个案例中被IC类药物促进.
- 与单波回入相比,双波回入的心动节拍表现出更长的周期长度 (197 ± 11毫秒) 和更大的刺激间隙 (71 ± 16毫秒).
结论:
- 双波再入是一种在编程电刺激过程中进行心室动脉冲动加速的机制.
- 心肌的异型特性在调节回入波传播方面发挥着重要作用.
- 双波再进入对理解前节律失常药物效应和快速心室高心率的病理生理学有潜在的临床影响.
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