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首页> 美国卫生研究院文献>Journal of Zhejiang University. Science. B >Simulation of inter atrial block based on a human atrial model
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Simulation of inter atrial block based on a human atrial model

机译：基于人房模型的房间传导阻滞仿真

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Inter atrial block (IAB) is a prevailing cardiac conduction abnormality that is under-recognized in clinical practice. IAB has strong association with atrial arrhythmia, left atrial enlargement, and electromechanical discordance, increasing the risk of atrial fibrillation (AF) and myocardial ischemia. IAB was generally believed to be caused by impaired conduction along the Bachmann bundle (BB). However, there are three other conduction pathways, including the fibers posteriorly in the vicinity of the right pulmonary veins (VRPV), transseptal fibers in the fossa ovalis (FO), and muscular bundles on the inferior atrial surface near the coronary sinus (CS). We hypothesized that the importance of BB on IAB might have been overestimated. To test this hypothesis, various combinations of conduction pathway blocks were simulated based on a realistic human atrial model to investigate their effects on the index of clinical diagnosis standard of IAB using a simulated 12-lead electrocardiogram (ECG). Firstly, the results showed that the BB block alone could not generate typical P wave morphology of IAB, and that the combination of BB and VRPV pathway block played important roles in the occurrence of IAB. Secondly, although single FO and CS pathways play subordinate roles in inter atrial conduction, their combination with BB and VRPV block could also produce severe IAB. In summary, this simulation study has demonstrated that the combinations of different inter atrial conduction pathways, rather than BB alone, resulted in ECG morphology of IAB. Attention needs to be paid to this in future pathophysiological and clinical studies of IAB.
机译：房间传导阻滞（IAB）是一种普遍存在的心脏传导异常，在临床实践中并未得到充分认识。 IAB与房性心律不齐，左房增大和机电不协调密切相关，从而增加了房颤（AF）和心肌缺血的风险。通常认为，IAB是由沿巴赫曼束（BB）的传导受损引起的。但是，还有其他三种传导途径，包括右肺静脉附近的纤维（VRPV），卵圆窝的后隔纤维（FO）以及冠状窦附近的下房表面的肌束（CS）。 。我们假设BB对IAB的重要性可能被高估了。为了验证这一假设，基于现实的人心房模型对传导通路阻滞的各种组合进行了模拟，以使用模拟的12导联心电图（ECG）研究其对IAB临床诊断标准指标的影响。首先，结果表明，单独的BB阻滞不能产生IAB的典型P波形态，并且BB和VRPV通路阻滞的结合在IAB的发生中起重要作用。其次，尽管单一的FO和CS通路在心房传导中起次要作用，但它们与BB和VRPV阻滞相结合也可能产生严重的IAB。总之，该模拟研究表明，不同的心房传导途径（而不是单独的BB）的组合会导致IAB的ECG形态。在IAB的未来病理生理和临床研究中需要对此进行关注。

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