房间隔单线消融防治犬实验性心房颤动的研究  

Effect of Simple Linear Septal Ablation on Eliminating Experimental Atrial Fibrillation in Dogs

作　　者：刘彤[1] 胡大一[1] 郭成军[1] 杨新春[1] 商丽华[1] 张建军[1] 张勇[1] 许玉韵[1] 戚龙[1] 王英亮 

机构地区：[1]首都医科大学心血管病研究所

出　　处：《中国心脏起搏与心电生理杂志》1999年第3期143-145,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：卫生部科学研究基!(批准号为 96 -1-3 0 1);北京市自然科学基金!(批准号为796 2 0 11)

摘　　要：为探讨房间隔单线消融治疗心房颤动 (AF)的可行性 ,选用 13只犬 ,在静脉滴注乙酰甲胆碱下 ,用心房快速起搏诱发持续性 AF(持续时间 >15 min)。经皮穿刺静脉 ,在 X线透视下用 7F温控 4极同步导管介导射频能量线性消融卵圆窝前方的宽厚房间隔。观察消融前、后 AF的诱发率及电生理参数变化。结果显示消融前所有犬均可诱发持续性 AF。消融前 2只犬死亡。间隔消融后 8只犬不再诱发 AF,1只犬诱发持续性心房扑动 (AFL) ,再消融三尖瓣环和下腔静脉间心肌后 AFL消失。另 2只仍可诱发 AF。消融后卵圆窝心房有效不应期 (ERP)较消融前延长(113± 9ms vs67± 7ms,P<0 .0 5 ) ,其余部位消融前后 ERP无显著性差异。结果初步提示房间隔单线消融能够防治实验性 AF的发生 ,对于临床上有相似特点的 AF消融房间隔可能有效。To test the hypothesis that a simplified septal linear ablation could be effective on eliminating atrial fibrillation (AF),13 dogs underwent temperature controlled endocardial linear ablation across the thick septal portion in front of fossa ovalis (FO) at closed chest state.Sustained AF (>15 min) was induced using burst pacing during infusion of methacholine.Electrophysiologic parameters were recorded before and after ablation.For the thirteen dogs under spetal ablation,two dogs died during methacholine infusion prior to ablation.Sustained AF became noninducible after septal abalation in 8 dogs during infusion of methacholine of 3.0 μg/kg per minute.After septal ablation,one dog had sustained atrial flutter (>15 minutes) induced by burst atrial pacing and no atrial flutter occured after a lesion ablation between the tricuspid annulus and the inferior vena cava.Sustained AF was still inducible by infusion of methacholine of a high dose in 2 dogs.The atrial effective refractory period was prolonged only in FO (113±9 ms vs 67±7 ms, P <0.05).The results indicate that the septal ablation may eliminate AF mediated by vagal activity.It might also be useful for ablation of human AF with identical critical site at atrial septum.

关 键 词：心房颤动 射频消融 实验研究 

分 类 号：R541.750.5[医药卫生—心血管疾病]