Full Text:   <1347>

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CLC number: R540.4

On-line Access: 2019-04-01

Received: 2018-08-07

Revision Accepted: 2018-10-29

Crosschecked: 2019-03-02

Cited: 0

Clicked: 3630

Citations:  Bibtex RefMan EndNote GB/T7714

 ORCID:

Ling Xia

https://orcid.org/0000-0002-1937-9693

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Journal of Zhejiang University SCIENCE B 2019 Vol.20 No.4 P.300-309

http://doi.org/10.1631/jzus.B1800420


Simulation of inter atrial block based on a human atrial model


Author(s):  Yuan Gao, Ying-lan Gong, Ling Xia, Ding-chang Zheng

Affiliation(s):  Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, Zhejiang University, Hangzhou 310027, China; more

Corresponding email(s):   xialing@zju.edu.cn

Key Words:  Inter atrial block, Electrocardiogram, Simulation, Heart model


Yuan Gao, Ying-lan Gong, Ling Xia, Ding-chang Zheng. Simulation of inter atrial block based on a human atrial model[J]. Journal of Zhejiang University Science B, 2019, 20(4): 300-309.

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author="Yuan Gao, Ying-lan Gong, Ling Xia, Ding-chang Zheng",
journal="Journal of Zhejiang University Science B",
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publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1800420"
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DOI - 10.1631/jzus.B1800420


Abstract: 
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.

基于人体心房模型的房间阻滞仿真

目的:探究不同心房间传导通道阻滞的组合对形成房间阻滞的影响及体表心电图变化,探究房间阻滞的产生机理.
创新点:通过仿真证明了单一Bachmann束阻滞并不能产生典型的房间阻滞P波时长和波形,并结合电兴奋传导时序,解释了房间阻滞的产生机理.
方法:通过64位螺旋电子计算机断层扫描(CT)扫描人体心房,构建心房解剖模型.阻断不同的心房间传导通道,以单域方程仿真出心房电兴奋传导时序,采用边界元法计算各时刻人体体表电位,进而计算出P波波形.
结论:要使P波时长和形态均满足临床诊断房间阻滞的条件,必须同时阻断Bachmann束和右肺静脉后部的穿间隔纤维(VRPV)通道,这为进一步了解房间阻滞的发病机制及未来临床研究提供了指导.

关键词:房间阻滞;心电图;仿真;心脏建模

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

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