摘要
目的 :观察 Marshall韧带 (L OM)的电生理学特点及其组织形态 ,探讨 L OM在局灶性房颤发病机制中的地位。方法 :选用健康犬 8只 ,放置心内电极导管和心外膜电极 ,同步记录高位右房 (HRA) ,左心耳 (L AA) ,L OM的电活动。射频消融 L OM靠近冠状窦的部位。比较消融前后 HRA- L AA间期 ,HRA- L AM(左房 )间期 ,HRA- L OM间期 ,L AM- L OM间期。切取 L OM,进行组织学观察。结果 :窦性心律时 ,在 L OM上可以记录到双电位 ,前者是 L AM电位 ,后者是 L OM电位 ,消融 L OM靠近冠状窦的部位 ,L OM电位消失 ,消融前后 ,HRA- L AA间期、HRA- L AM间期对比无显著性差异 (P>0 .0 5 )。组织切片显示 L OM内含有心肌组织 ,与深层左房肌被脂肪层隔离 ,脂肪层内含有大量的神经组织。结论 :L OM电位是 L OM内心肌组织产生的 ,L OM可能是局灶性房颤的起源部位之一。射频消融 L OM靠近冠状窦的部位对左右房间传导无影响。对起源于 L OM的局灶性房颤 ,消融这一部位可能有效。
AIM: To investigate the roles of ligament of Marshall in mechanism of focal atrial fibrillation by studying the electrophysiological characteristic and morphology. METHODS: Eight healthy dogs were chosed. Epicardial electrodes and endocardial electrodes were placed. The electroactivities were recorded at high right atrium(HRA), left atrial appendage(LAA), ligament of marshall(LOM) synchronously. The part of ligament of Marshall near coronary sinus(CS) was ablated. HRA LAA internal, HRA left atrial muscle(LAM) internal, HRA LOM internal, LAM LOM internal were compared before and after ablation. LOMs were cut off, studied with histology method. RESULTS: Double electrical potentials (LAM potential and LOM potential) were recorded on ligament of Marshall in sinus rhythm. LOM potential disappeared after ablating the part of LOM near CS. HRA LAA internal and HRA LAM internal didn't change apparently after ablation. Morphologic observation suggested that there was cardiac muscle in the ligament of Marshall. There were a lot of nervous tissues near the ligament. CONCLUSION: LOM potential originates from the cardiac muscle in LOM. Ablation on the part of LOM near the CS doesn't influence conduction between left and right atrium. Some focal atrial fibrillations maybe result from LOM. It is possible to ablate the LOM to cure the focal atrial fibrillation by eliminating the LOM potential.
出处
《心脏杂志》
CAS
2001年第2期95-97,共3页
Chinese Heart Journal
基金
国家自然科学基金!( No.3 9770 3 2 7)
