心房颤动维持机制的新观点--"肺静脉-左心房折返"假说

现阶段关于心房颤动的维持机制的两种主要假说，即心房“多发子波折返”和“肺静脉驱动伴颤动样传导”均难以全面解释电学隔离肺静脉治疗心房颤动的机制。研究证实，在肺静脉和左心房之间具有形成折返激动的必备基础，而且心房颤动持续过程中的肺静脉电活动具有提示折返激动的特征，并高度依赖于左心房电活动的存在。基于此，作者提出心房颤动维持的“肺静脉-左心房折返”假说，并阐述了其理论基础与意义。

Maintenance Mechanism of Atrial Fibrillation--"A Pulmonary Vein-Left Atrium Reentry" Hypothesis

There are two major hypotheses about the maintenance mechanism of atrial fibrillation, that is, multiple wavelet reentry hypothesis and pulmonary veins elicited conduction accompanied with fibrillation. However, neither of them can fully explain the mechanism of electrical isolation of pulmonary veins as a management for atrial fibrillation. Researches have proved that the area between left atrium and pulmonary veins can provide the basis for reentry and that the electric activity of pulmonary veins during the maintenance of atrial fibrillation, which highly depends on left atrial electric activity, is indicative of reentry. Based on all these, the author of this article proposes the hypotheses of reentry between pulmonary vein and left atrium, and expound its rationale and clinical significance.