调节束起源室性心律失常的研究进展  

Research progress on ventricular arrhythmia originating from moderator band

作　　者：沈瑞环 邹彤[1,2,3] SHEN Rui-huan;ZOU Tong(Department of Cardiology,Beijing Hospital,Peking Union Medical College,Beijing,100730,China;National Center of Gerontology,Peking Union Medical College,Beijing,100730,China;Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing,100730,China)

机构地区：[1]北京协和医学院北京医院心血管内科,北京100730 [2]北京协和医学院国家老年医学中心,北京100730 [3]北京协和医学院中国医学科学院老年医学研究院,北京100730

出　　处：《心脏杂志》2023年第1期102-105,共4页Chinese Heart Journal

基　　金：北京市科委重大科技项目资助(Z171100001017203,D181100000218005)。

摘　　要：调节束是一个位于右室心腔内的条索状肌性结构,两端分别延伸至右室前间隔流入道下缘和右室游离壁前乳头肌根部,其内有右束支通过。越来越多的研究指出调节束可能是无结构性心脏病变病人室性心律失常的起源之一。起源于此的室性心律失常常表现为室性期前收缩或室性心动过速。此外,某些触发多形性室速和特发性室颤(idiopathic ventricular fibrillation, IVF)的短联律间期室早也被发现起源于调节束,而消融这些室性心律失常能有效预防室颤复发,因此,有效识别相应的心电图异常并及时予以消融可能是治疗IVF的新靶点。目前,调节束导致心律失常的确切机制仍存争议,本文就调节束起源的室性心律失常的流行病学、解剖生理、发病机制、心电图特征与消融治疗的研究进展进行综述,为研究、预防和治疗调节束起源的室性心律失常提供参考。The moderator band is a striped muscular structure located in the cardiac chamber of the right ventricle, which extends respectively to the inferior edge of the inflow tract of the anterior septum of the right ventricle and passing through it. More and more studies have pointed out that the moderator band may be one of the origins of ventricular arrhythmias in patients without structural heart disease.Ventricular arrhythmias originated from the moderator band are often characterized by ventricular extrasystole or ventricular tachycardia. In addition, some short coupling interval ventricular premature beats that trigger polymorphic ventricular tachycardia and idiopathic ventricular fibrillation(IVF) have also been found to originate from the moderator band, and ablation of these ventricular arrhythmias can effectively prevent the recurrence of ventricular fibrillation. Therefore, effective identification of corresponding ECG abnormalities and timely ablation may be a new target for the treatment of IVF. At present, the exact mechanism of arrhythmia caused by the moderator band is still controversial. In this paper, the epidemiology, anatomy and physiology, pathogenesis, electrocardiographic characteristics and ablation treatment of ventricular arrhythmias originated from the moderator band are reviewed in order to provide reference for the research, prevention and treatment of ventricular arrhythmias originated from the moderator band.

关 键 词：调节束 室性心律失常 特发性室颤 

分 类 号：R541.7[医药卫生—心血管疾病]