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消融犬心脏脂肪垫对电刺激诱发房颤的影响
王洪涛郑强荪董建军杨玉辉刘雄涛卢延生洪昌明
0
(第四军医大学唐都医院心脏内科,西安710038)
摘要:
目的:研究消融犬心脏脂肪垫对电刺激诱发房颤的影响。方法:选用22只犬麻醉后经正中开胸(2只于开胸后不久死于室颤)暴露主动脉根部和上腔静脉中部的第三脂肪垫(SVC—AOFP)、右肺静脉脂肪垫(RPVFP)及下腔静脉、左房交界处脂肪垫(IVC—LAFP)。采用7F大头导管消融脂肪垫。分别测定基础状态下、脂肪垫消融后的心房有效不应期(AERP)、不应期离散度(dAERP)及肺静脉有效不应期(PVERP)。分别从左上肺静脉采取S1S1、S1S2两种诱发方案,在基础状态下及脂肪垫消融后分别诱发房颤。结果:(1)脂肪垫消融后与基础状态下比较:AERP自(137±16)ms延长至(147±16)ms;dAERP自(17.0±4.6)ms缩短至(12.0±4.3)ms;PVERP自(131±14)ms延长至(141±9)ms,消融后与基础状态下相比有显著性差异(P〈0.05)。(2)消融后以S1S1或S1S2刺激方案再次诱发房颤,S1S1平均起搏周长自(173±25)ms缩短至(145±21)ms,起搏周长消融前后相比有显著性差异(P〈0.05)。S1S2刺激未能诱发。结论:消融犬心脏脂肪垫影响肺静脉和心房的电重构,不利于房颤的诱发。[著者文摘]
关键词:  心脏 肺静脉 脂肪组织 导管消融术 心房颤动 电生理学技术 心脏
DOI:10.3724/SP.J.1008.2006.01333
基金项目:
Influence of ablated cardiac fat pad on atrial fibrillation induced by a single extra-stimulus in dogs
WANG Hong-tao, ZHENG Qiang-sun, DONG Jian-jun,YANG Yu-hui, LIU Xiong-tao, LU Yan-sheng, HONG Chang-ming
(Department of Cardiology, Tangdu Hospital,Fourth Military Medical University, Xi'an 710038,China)
Abstract:
Objective:To study the influence of ablated cardiac fat pad on atrial fibrillation induced by a single extra-stimulus in dogs. Methods: Twenty-two dogs were anesthetized and their chest cavity was openned through a median sternotomy (2 dogs died of fibrillation immediately after opening) to expose the 3 cardiac fat pads: the medial superior vena cava and aortic root fat pad (SVC-Ao FP), the right pulmonary vein-atrial junction fat pad (RPV FP), and the inferior vena cava-left atrial junction fat pad (IVC-LA fat pad). The atrial effective refractory period (AERP), dispersion of AERP (dAERP), and pulmonary vein effective refractory period(PVERP)were measured under baseline and after ablation of the 3 fat pads. The left superior pulmonary veins were stimulated by SiSlbursting stimulation and S1 S2 program stimulation to induce atrial fibrillation before and after ablation. Results: After ablation, AERP increased from (137+16) ms to (147±16) ms and PVERP increased from (131±14) ms to (141±9) ms,while dAERP decreased from (17.0±4. 6) ms to (12.0±4. 3) ms (P〈0.05). After ablation, SISa cycle length decreased from ( 173 ± 25) ms to ( 145 ±21) ms when used for restimulation after ablation( P〈0. 05 ). S1S2 could not induce AF again. Conclusion: Ablation of the 3 cardiac fat pad can influence the electrical remodeling of the atrial and the pulmonary vein,which may hamper the induction of atrial fibrillation.[著者文摘]
Key words:  Department of Cardiology, Tangdu Hospital,Fourth Military Medical University, Xi'an 710038,China