Focal of early depolarization in the synoatrial area of the right athlete in a person before ancient and at drug addict
Abstract
Aim. Alternative ideas on initiation of heart rhythm permitted to reveal the influence of central rhythmogenesis on forming an early depolarization zone in the sinoatrial area of the heart.
Methods and results. 10 patients were observed within the framework of the research. A circular catheter Lasso NAV with ten electrode couples was inserted via femoral vein and moved along it and other veins to the right atrium cavity. An electroanatomic isochronous map of the right atrium was obtained implementing CARTO 3 system. While creating the isochronous map of the right atrium at sinus rhythm, an electrogram signal received from a QRS in II lead surface ESG was chosen as a reference channel. At least 500 activation points were defined in the right atrium cavity. The same conditions were observed while mapping the right atrium before and after anesthesia. The area of early activation in right atrium, with location corresponding to the sinoatrial area, was 73.5% smaller with anesthesia than without it.
Conclusion. The results give us ground to suppose that when a patient is not anesthetized the sinoatrial area of the right atrium synchronizes with the rhythm of neuronal signals coming from the brain simultaneously to pacemaker pools of the sinoatrial node of human heart which determines larger area of early depolarization. Anesthesia suppresses neuronal activity of the brain and early activation process takes place only due to automatic structures of the sinoatrial node which results in a smaller area of early depolarization in the node.
Keywords:sinoatrial node, early depolarization zone, mapping
Clin Experiment Surg. Petrovsky J. 2018; 6 (4): 49–54.
doi: 10.24411/2308-1198-2018-14007. Received: 24.10.2018. Accepted: 19.10.2018.
References
1. Abramochkin D.V., Sukhova G.S., Rozenshtrauh L.V. Mechanisms of functioning and regulation of mammalian sinoatrial nodeUspekhi fiziologicheskikh nauk [Advances in Physiological Sciences]. 2009; 40 (4): 21–41. (in Russian)
2. Yaniv Y., Ahmet I., Liu J., Lyashkov A.E., et al. Synchronization of sinoatrial node pacemaker cell clocks and its autonomic modulation impart complexity to heart beating intervals. Short title: beating-rate variability of sinoatrial node cells. Heart Rhythm. 2014; 11 (7): 1210–9.
3. Pokrovskii V.M. Alternative view the mechanism of cardiac rhythmogenesis. Heart Lung Circ. 2003; 12: 1–7.
4. Pokrovskii V.M. Integration of the heart rhythmogenesis lev- els: heart rhythm generator in the brain. J Integr Neurosci. 2005; 4 (2): 161–8.
5. Pokrovskii V.M. Hierarchy of the heart rhythmogenesis levels is a factor in increasing the reliability of cardiac activity. Med Hy- potheses. 2006; 66: 158–64.
6. Suga H., Oshima M. Modulation-characteristics of heart rate by vagal stimulation. Jpn J Med Electronics Biol Eng. 1968; 6: 465–71.
7. Reid J.V. The cardial pacemaker: Effects of regularly spaced nervous input. Am Heart J. 1969; 78: 58–64.
8. Levy M.N., Martin P.J., Iano T., Zieske H. Paradoxical effect of vagus nerve stimulation on heart rate in dogs. Circ Res. 1969; 25: 303–14.
9. Pokrovskii V.M., Abushkevich V.G., Fedunova L.V. Electrophysiological marker of controlled bradycardia. Doklady RAN [RAS Reports]. 1996; 349 (3): 418–20. (in Russian)
10. Shenasa M., Borggrefe M., Breithardt G. Cardiac mapping. 2nd. ed. New York, 2003: 784 р.
11. Ramanathan C., Jia P., Ghanem R., Ryu K., et al. Activa- tion and repolarization of the normal human heart under complete physiological conditions. Proc Natl Acad Sci USA. 2006; 103 (16): 6309–14.
12. Mazurov M.E. Rhythmogenesis in the sinoatrial heart node. Biofizika [Biophysics]. 2006; 51 (6): 1092–99. (in Russian)
13. Mazurov M.E. Mathematical models in biology, ecology and chemistry. Conference series "Mathematics. Computer. Education"). 2006; 2; 371–83. (in Russian)
14. Mazurov M.E. Rhythmogenesis in the sinoatrial heart nodeBiofizika [Biophysics]. 2009; 54 (1): 89–96. (in Rus- sian)
15. Pokrovskii V.M.,Abushkevich V.G., Gurbich D.V., Kly- kova M.S., et al. Interaction of brain and intracardiac levels of rhythmogenesis hierarchical system at heart rhythm formation. J Integr Neurosci. 2008; 7 (4): 457–62.