心房細動においてNaチャンネル遮断薬が及ぼすSpiral waveへの影響 : Luo-Rudyモデルを用いたコンピュータシミュレーションによる検討

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Meandering spiral wave (SW) has recently become well known as an activation propagation pattern of atrial myocardium during the atrial fibrillation (AFib). The purpose of this study is to clarify the effect of the pure sodium channel blocker on the behavior of the SW by using computer simulation with Luo-Rudy ionic model. After the SW was induced in 3 sheets of 2-dimensional excitable matrices corresponding to 100×100mm isolated atrial myocardial tissue, the sodium current (iNa) of the whole matrix was suppressed to 90% in model 2,to 80% in model 3,whereas not suppressed in model 1. The behavior of the SW was observed until 15,000msec after induction. The meandering was expressed by drawing the orbit of the SW tip. The unipolar electrogram (ECG) was calculated at 10mm over the center of the matrix. In the model 1,the SW was sustained with its tip meandering at the limited small region. The ECG revealed the fibrillation-like irregular waveform with a short cycle length. In the model 2,although the meandering region was larger than that in the model 1,the SW was not terminated. The ECG revealed the irregular waveform, but its cycle length was longer than that in the model 1. In the model 3,the meandering region was further enlarged compared to that in the model 2. The SW was terminated at 13,072msec after AFib was induced, when the meandering tip rushed out of the matrix. The ECG revealed the flutter-like waveform with a long cycle length before the SW was terminated. The iNa suppression would contribute to defibrillation by making the SW tip meander over the large region and rush out of the myocardium.
香川県立保健医療大学の論文

心房細動においてNaチャンネル遮断薬が及ぼすSpiral waveへの影響 : Luo-Rudyモデルを用いたコンピュータシミュレーションによる検討

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