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。
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.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2006年第12期1333-1335,共3页
Academic Journal of Second Military Medical University
基金
军队"十五"医药卫生科研基金资助项目(01MB126).~~
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
heart
pulmonary veins
adipose tissue
catheter ablation
atrial fibrillation
electmphysiologic techniques,cardiac
