Case report: Mechanical-electric feedback and atrial fibrillation-Revelation from the treatment of a rare atrial fibrillation caused by annular constrictive pericarditis.

病例报告 ： 机械电反馈和心房颤动 - 环形缩窄性心包炎引起的罕见心房颤动的治疗启示。

• 影响指数: 5.846
• 发表时间: 2023
• 来源期刊: Front Cardiovasc Med
• DOI: 10.3389/fcvm.2023.1100425
• PMID: 36760571
• 文章类型: Case Reports
• 作者列表: Yi D,Li L,Han M,Qiu R,Tao L,Liu L,Liu C

关键词: annular constrictive pericarditis; atrial fibrillation; atrioventricular groove; mechanical-electric feedback; predisposing factors

Abstract

Atrial fibrillation (AF) is one of the most common arrhythmias encountered in clinical practice. The pathophysiological mechanisms responsible for its development are complex, vary amongst individuals, and associated with predisposing factors. Here, we report a case of AF caused by annular constrictive pericarditis (ACP), which is extremely rare due to its unusual anatomical form. In our patient, AF was refractory to multiple antiarrhythmic medications; however, spontaneous conversion to sinus rhythm occurred when the ring encircling the right and left ventricular (RV and LV) cavities along the atrioventricular (AV) groove was severed. This suggests that atrial stretch due to atrial enlargement and increased left atrial (LA) pressure may contribute to the initiation and maintenance of AF. This report highlights the importance of the careful investigation of rare predisposing factors for AF using non-invasive diagnostic approaches and mechanical-electric feedback (MEF) as a pathophysiological mechanism for AF initiation and maintenance.

摘要

心房颤动（AF）是临床实践中最常见的心律失常之一。负责其发展的病理生理机制是复杂的，因个人而异，并与诱发因素有关。这里,我们报告一例由环状缩窄性心包炎（ACP）引起的房颤，由于其不寻常的解剖形式，这是极其罕见的。在我们的病人身上，AF对多种抗心律失常药物是难治性的；然而，当沿着房室（AV）沟环绕右心室和左心室（RV和LV）腔的环被切断时，发生了自发的窦性心律转换。这表明，由于心房扩大和左心房（LA）压力增加导致的心房拉伸可能有助于房颤的启动和维持。本报告强调了使用非侵入性诊断方法和机械电反馈（MEF）作为房颤启动和维持的病理生理机制，仔细研究房颤的罕见诱发因素的重要性。