折返机制被认为是维持大多数快速性心律失常的基础，见图8-1。最典型的临床折返环路模型为各种形式的心房扑动，涉及上或下腔静脉、三尖瓣环等，因为环路周围存在着结构上的障碍。Wolff-Parkinson-White（W-P-W）预激综合征中的束支折返和折返性快速性心律失常也起因于在解剖学上决定的路径。发生于结构性心脏疾病（例如缺血、梗死和心力衰竭）的许多形式的室性心动过速常常由解剖学上预先决定的折返路径维持。心室浦肯野纤维网也被认为可提供结构上的折返环路。反射是心室梗死时发生折返性期外收缩和部分室性二联律的机制。第2位相折返被认为启动了Brugada综合征时心室纤维性颤动及心肌梗死急性期时室性心律失常。心房和心室纤维性颤动（发生于几乎全部可遇见状况，例如缺血、梗死、重塑、肥大和应激反应）主要由折返机制维持。多形性室性心动过速（尖端扭转性）相关联的各种类型QT综合征也被认为由折返机制维持。
参考文献
[1] Antzelevitch C. Mechanisms of cardiac arrhythmia and conduction disturbances. In:Fuster V, O’Rourke RA, Walsh RA, Poole-Wilson P, eds. Hurst’s The Heart. 12th ed.New York, NY: McGraw Hill, 2007:913-945.
[2] Antzelevitch C, Burashnikov A, Di Diego JM. Mechanisms of cardiac arrhythmias.In: Gussak I, Antzelevitch A, eds. Electrical Diseases of the Heart. London: Springer-Verlag, 2008:65-132.
[3] Burashnikov A, Antzelevitch C. Late-phase 3 EAD. A unique mechanism contributing to initiation of atrial fibrillation. PACE, 2006, 29:290-295.
[4] Nattel S. New ideas about atrial fibrillation 50 years on. Nature, 2002, 415:219-226.
[5] Rho RW, Page RL. Ventricular arrhythmias. In: Fuster V, O’Rourke RA, Walsh RA,et al., eds. Hurst’s The Heart. 12th ed. New York, NY: McGraw Hill, 2007:1003-1019.
[6] Waldo AL, Wit AL. Mechanisms of cardiac arrhythmia and conduction disturbances.In: Fuster V, Alexander RW, O’Rourke RA, eds. Hurst’s The Heart. 11th ed. New York, NY: McGraw Hill, 2004: 787-816.
[7] Wit AL, Rosen MR. Afterdepolarizations and triggered activity: Distinction from automaticity as an arrhythmogenic mechanism. In: Fozzard HA, Haber E, et al., eds.The Heart and Cardiovascular System. 2nd ed. New York, NY: Raven, 1992:2113–2163.
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