为了分析早期后除极(early afterdepolarizations,EADs)诱发室颤的机理,本研究基于精细的浦肯野纤维网络与心室解剖数据,构建了一个三维心室电传导模型.基于该模型,模拟了产生早期后除极的电生理变化,探讨了三种心室细胞的早期后除极的易感性,分析了早期后除极易感细胞对折返波的影响,最后定量比较早期后除极诱发室颤的伪心电图的改变情况.实验结果表明:中间层细胞早期后除极易感性最强,中间层细胞早期后除极的产生能够导致折返波破裂,并且在心电图中表现为紊乱的不规则的颤动心律,这与之前在动物实验观察得到的现象一致,因此中间层细胞可能是一个诱发室颤的重要靶点.
Based on the Purkinje system and the anatomically detailed ventricular geometry of a human heart, an integrated 3D human ventricular conduction model is proposed to simulate the reentry wave propagation for studying the generation mechanism of ventricular fibrillation caused by early afterdepolarizations. This model was simulated the cardiac cell electrical activity of early afterdepolarizations and the susceptibility to early afterdepolarizations of three kinds of cells. Then, the influence of cells which is susceptibility to early afterdepolarizations on the reentrant spiral wave dynamics was analyzed. Finally the ECG waveform under ventricular fibrillation caused by early afterdepolarizations was quantified. The experimental results showed that the middle cells are most likely to generate early afterdepolarizations. With generating early afterdepolarizations in middle cells, the reentrant wave would be broken up and the ECG waveform would be disordered and irregular,which was in agreement with the results obtained on animal models. Therefore, it may be an important target for inducing ventricular fibrillation.