| 摘要: |
| 目的 观察射频消融左上肺静脉脂肪垫(left superior pulmonary vein fat pad,LSPV-FP)对心房颤动(AF)的影响。方法 12只健康杂种犬,麻醉插管后持续心电监测；于双侧颈部暴露迷走神经干,左右侧第4肋间开胸并暴露LSPV-FP；分别测量基础、刺激迷走神经、消融LSPV-FP、刺激迷走神经+消融LSPV-FP 4种状态下的心房及左上肺静脉有效不应期(ERP)和有效不应期离散度(dERP)、AF诱发率、AF时心室率。结果 基础状态下,刺激左侧或右侧迷走神经干可明显缩短心房ERP[(84.44±29.50) ms vs (129.7±15.83) ms, (85.42±26.11) ms vs (129.7±15.83) ms, P<0.05]、增大dERP[(71.67±14.03) ms vs (34.17±18.32) ms,(57.5±24.17) ms vs (34.17±18.32) ms, P<0.05]、增大左上肺静脉近端与远端ERP的差异(P<0.05)、增加AF的诱发率[(5.33±1.231)次 vs (0.75±0.96)次, (4.67 ± 1.155)次 vs (0.75±0.96)次, P<0.05]及降低AF时心室率[(143.6±22.42)次/min vs (226.3±28.50)次/min, (146.4±30.72)次/min vs (226.3±28.50)次/min, P<0.05]。消融LSPV-FP可以逆转刺激左侧迷走神经干所致的上述变化(P<0.05),但对右侧迷走神经刺激干所致的电生理变化无显著影响。结论左侧迷走神经干纤维部分通过LSPV-FP对心房颤动的触发或维持发挥作用。 |
| 关键词: 导管消融术 左上肺静脉脂肪垫 有效不应期 有效不应期离散度 心房颤动 |
| DOI：10.3724/SP.J.1008.2011.0969 |
| 投稿时间：2011-05-16修订日期：2011-08-03 |
| 基金项目:国家自然科学基金(30570361). |
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| Effect of left superior pulmonary vein fat pad on atrial fibrillation in dogs |
| YANG Zhi-jian1,XIA Yang2,ZHAO Liang2,ZHANG Jia-you2,JIANG Shu-jun1,LIAO De-ning2* |
(1. Department of Second Cadre Ward, Navy General Hospital of PLA, Beijing 100048, China
2. Department of Cardiology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
*Corresponding author.) |
| Abstract: |
| ObjectiveTo explore the effect of ablation of left superior pulmonary vein fat pad(LSPV-FP) on atrial fibrillation(AF). MethodsTwelve healthy adult mongrel dogs were anesthetized and ventilated; both cervical vagosympathetic trunks were exposed for stimulation. Thoracotomies at the 4th intercostal space of left and right chest were performed to expose the LSPV-FP. The effective refractory period(ERP)/ERP-dispersion (dERP) of atrium and LSPV, AF inducibility, and the ventricular rate of AF were measured in the following statuses: baseline, vagosympathetic trunk stimulation(VTS), LSPV-FP ablation, and VTS post LSPV-FP ablation. ResultsAt baseline status, stimulation of the left or right vagosympathetic trunks significantly shortened the ERP of atrial ( \[84.44±29.50\] ms vs \[129.7±15.83\] ms, \[85.42±26.11\] ms vs \[129.7±15.83\] ms, P<0.05), increased the dERP of atrial ( \[71.67±14.03\] ms vs \[34.17±18.32\] ms,\[57.5±24.17\] ms vs \[34.17±18.32\] ms, P<0.05), the difference of ERP between proximal and distal of LSPV(P<0.05),AF inducibility ( \[5.33±1.231\] times vs \[0.75±0.96\] times, \[4.67±1.155\] times vs \[0.75±0.96\] times, P<0.05), and deceased the ventricular rate of AF(\[143.6±22.42\] beats/min vs \[226.3±28.50\] beats/min, \[146.4±30.72\] times/min vs \[226.3±28.50\] times/min, P<0.05). LSPV-FP ablation significantly attenuated all the above electrophysiological changes induced by left VTS(P<0.05), but showed no effects on those induced by right VTS. Conclusion Left vagosympathetic trunk plays an important role in the development and maintenance of AF partially through LSPV-FP. |
| Key words: catheter ablation left superior pulmonary vein fat pad effective refractory period effective refractory period-dispersion atrial fibrillation |
