司机是经常发生的还是短暂的? 来自持续性心房的连续映射的观察结果
Bram Hunt1,2,3, Eugene Kwan1,2,3, Eric Paccione1,2,3
1Department of Biomedical Engineering, 36 S. Wasatch Drive, SMBB 3100, University of Utah, Salt Lake City, UT 84112, USA.
概括
持续性心房动的驱动因素可以在六个月内复发,这表明治疗的稳定目标. 这些驱动因素与心脏纤维化有关,表明它们持久性的结构基础.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗成像医学成像
背景情况:
- 持续性心房动 (persAF) 机制,包括旋转重新进入和宫外焦点 (驱动器),是干预的关键目标.
- 目前针对persAF的基于驾驶员的干预措施显示出混合的临床成功,可能是由于对驾驶员随时间的稳定性缺乏了解.
研究的目的:
- 调查持续性心房动的司机的长期稳定性和复发情况.
- 为了测试驾驶员可以保持稳定并在几个月内复发的假设.
主要方法:
- 连续电生理学研究在18只狗身上进行,在1,3个月和6个月时诱导持续性心房动.
- 一个高密度的64电极导管被用来记录内心电图在左心房和右心房,以识别司机.
- 晚期加多增强磁共振成像用于评估驾驶员位置的心脏纤维化.
主要成果:
- 在6个月的时间内,66%的病例 (73%在左心室,41%在右心室) 观察到复发性驱动因素.
- 在所有三个研究点中存在的多重重复的驱动因素占初始驱动因素的53%,在92%的动物中发现.
- 与非驾驶员站点相比,驾驶员站点的加多增强显著较晚,表明纤维化 (P = 0.04).
结论:
- 在6个月的时间里,在固定地点反复出现的司机证实了他们作为持续性心房动的稳定目标的潜力.
- 纤维化驱动因素的关联表明,潜在的结构基板有助于其持久性和复发.
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