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基于心房模拟的四种不同传导通路对房颤发生和维护影响研究 预览

Study on Effect of 4 Different Conduction Pathways on Initiation and Maintenance of Atrial Fibrillation Based on Atrial Simulation
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摘要 目的基于临床MRI图像,建立基于病人的个体特异性的三维仿真房颤模型,并利用模型诱发房颤,在此模型中验证双心房传导系统对房颤诱发和维持的影响。方法采集临床心房颤动患者MRI数据,共112张图片,使用这份MRI图像重建人类心房解剖模型,使用4种不同的传导通路来表示双向传导,即仅通过卵圆窝缘(LFO)的双向传导、仅通冠状窦(CS)的双向传导、通过LFO和CS的双向传导、LFO和CS均不能导电。结果在仅通过LFO进行双向传导模拟的案例中,诱发了与LFO和CS案例相同的折返。但是对于仅通过CS传导及LFO和CS都不能导电的两个案例,一个刺激位点诱发了仅持续2个周期就终止的非持续折返。另外两个位点诱发了与之前描述的两个案例相同的折返,即通过LFO和CS的双向传导模拟和仅通过LFO的双向传导模拟。结论模拟显示,不同于正常窦性心律下的影响模式,不同双向传导通路可能对AF的发生和维护的影响较小。 Objective In this study, computational modelling was used to study whether different conduction pathways have impact on the AF initiation and maintenance based on a human atrial model. Methods MRI images from one patient who has atrial fibrillation were used to reconstruct the human atrial anatomical model. The number of MRI images was 112. In order to study the effect of different conduction pathways to AF, 4 different atrial models were generated in this study, which were biatrial conduction via only LFO;biatrial conduction via only CS;biatrial conduction via both LFO and CS;model without biatrial conduction. Results In the case of biatrial conduction simulation via only LFO, the same re-entries were induced as in the LFO and CS case. But for the two cases of only CS conduction and both LFO and CS cannot conduct electricity, one stimulus site induced unsustained re-entry which only lasted for 2 cycles, and then terminated. The other two sites induced the same re-entries as in the previously described two cases, which were biatrial conduction simulation via both LFO and CS and only LFO. Conclusion Our simulation showed that these conduction pathways played a minor role in the re-entry initiation and maintenance, the possible explanation is that all the re-entries induced in our simulation is local drivers and maintained by fibrosis.
作者 欧阳昭连 张婷 徐东紫 樊瑜波 OUYANG Zhaolian;ZHANG Ting;XU Dongzi;FAN Yubo(Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Scince and Medical Engineering, Beihang University, Beijing, 100083;Institute of Medical Information (IMI), Chinese Academy of Medical Sciences(CAMS), Beijing,100020;Beijing Key Laboratory of Rehabilitation Engineering for Elderly, National Research Center for Rehabilittion Technical Aids, Beijing, 100176)
出处 《中国医疗器械杂志》 2019年第2期99-101,共3页 Chinese Journal of Medical Instrumentation
基金 国家重点研发计划(2016YFC0104805) 中央级公益性科研院所基本科研业务费项目(2016ZX330015).
关键词 计算建模 心房颤动 心房消融 computational modelling atrial fibrillation atrial ablation
作者简介 通信作者:樊瑜波,E-mail:yubofan@buaa.edu.cn.
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