肺静脉在心房颤动机制中的作用

心房颤动是最为常见的异常心脏节律。起搏电生理研究表明大多数心房颤动均为源自肺静脉壁内心肌组织(即肌袖)的异位搏动病灶所触发。但是,心房颤动肺静脉起源的机制尚未完全阐释,目前认为与肺静脉内心肌自律性升高,触发活动及折返有关。对心房颤动发生、发展及维持机制的研究,对于指导心房颤动的临床治疗具有重要的意义。

Role of Pulmonary Veins in Atrial Fibrillation Mechanism

Atrial fibrillation is the most common sustained tachyarrhythmia.Histologic data show that myocardial tissue of the left atrial wall extends into the pulmonary venous walls.Myocardial sleeves onto pulmonary veins have been recognized as a frequent site of origin of focal triggers for this arrhythmia.However,the exact mechanism of arrhythmogenicity in the pulmonary veins in man is still unknown.Abnormal automaticity,triggered activity and reentry have been suggested.In this review,we describe the histological and electrophysiological characteristics of pulmonary veins.Possible substrates for arrhythmogenesis in the PVs and the relation between structural,ultrastructural characteristics and electrical activation are also discussed.