摘要
心脏起搏器植入是当前症状性心动过缓的重要治疗措施,但研究显示植入起搏器的患者心房颤动(房颤)发生率明显增高。主要原因为起搏器植入术后引起心脏电重构和结构重构从而导致心房颤动的发生。起搏器植入引起电重构的机制包括离子通道、电耦合及电传导特性的异常变化;而结构重构包括心肌细胞凋亡、间质纤维化、心房形态结构和射血分数改变。本文主要从起搏器植入所致的心脏电重构和结构重构两方面讨论起搏器植入导致心房颤动的机制,并归纳近期新学说与新进展。
Pacemaker implantation is currently an important treatment for symptomatic bradycardia,but studies have shown that patients with pacemaker implantation have a significantly higher incidence of atrial fibrillation(AF). The main reason is the occurrence of atrial fibrillation due to electrical and structural remodeling of the heart after pacemaker implantation. The mechanism of electrical remodeling caused by pacemaker implantation includes abnormal changes of ion channel,electrical coupling and electrical conduction characteristics,while structural remodeling includes cardiomyocyte apoptosis,interstitial fibrosis and changes of atrial configuration and ejection fraction. This review mainly discusses the mechanism of atrial fibrillation caused by pacemaker implantation via two aspects of cardiac electrical remodeling and structural remodeling and further summarizsrecent new theories and new progresses.
作者
林大卫
王耀晟
LIN Dawei;WANG Yaosheng(Department of Cardiology,Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200092,China)
出处
《实用医学杂志》
CAS
北大核心
2020年第7期979-982,共4页
The Journal of Practical Medicine
基金
国家自然科学基金项目(编号:81974022)。
关键词
起搏器
心房颤动
电重构
结构重构
pacemaker
atrial fibrillation
electrical remodeling
structural remodeling
