心室不应期离散度及激动周期变异与心室颤动诱发的关系  

Association between the ventricular dispersion of refractoriness and variation of activation cycle length with the induction of ventricular fibrillation

作　　者：林长坚[1] 金奇[1] 张凝[1] 周建[1] 庞旸[1] 任淑静[1] 顾刚[1] 吴立群[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院心脏科,200025

出　　处：《中华心律失常学杂志》2011年第5期354-358,共5页Chinese Journal of Cardiac Arrhythmias

基　　金：国家自然科学基金（81070266,81000081）;上海市科委课题（10140903100）;上海高校创新团队发展计划

摘　　要：目的 研究不应期离散度及激动周期变异与心室颤动（VF）诱发的关系.方法 采用6只开胸犬,在其左心室前壁心外膜缝上一块含有12×12个单极电极（电极间距2mm）的电极板.采用连续起搏方法,分别记录300 ms、200 ms及诱发VF或失去1：1心室夺获前不应期及激动周期.通过不应期标准差及其变异系数测定不应期离散度,激动周期差值的绝对值之和及其均值评估激动周期变异大小.结果 有5只犬通过此刺激方案诱发VF,VF的诱发率为83.3％.与300 ms起搏时相比,200 ms起搏时心室不应期离散度及激动周期变异差别不明显,差异无统计学意义；与300 ms及200 ms起搏时相比,VF发生或失去1∶1心室夺获前心室不应期离散度及激动周期变异显著增大,差异有统计学意义.结论 心室不应期离散度及激动周期变异与VF诱发相关,两者变异增大易于促发VF.Objective The goal of this study is to test the association between the ventricular dispersion of refractoriness and variation of activation cycle length with the induction of ventricular fibrillation （VF）.Methods A plaque containing 12×12 unipolar electrodes （2 mm spacing） was sutured on the anterior epicardium of left ventricle in six open-chest beagles.The SISI restitution pacing protocol was used to evaluate the ventricular refractory periods and activation cycle lengths at the pacing cycle length （PCL） of 300 ms,200 ms and the one before inducing VF or losing 1 ∶ 1 capture.The dispersion of refractoriness was evaluated by the standard deviation and coefficient of variation of refractoriness.The variation of activation cycle length was assessed by the sum of the absolute differences of activation cycle length and its mean value.Results VF was induced in 5/6 （83.3%） beagles by this pacing protocol.Compared with the PCL of 300 ms,the ventricular dispersion of refractoriness and the variation of activation cycle length were not significantly changed by the PCL of 200 ms.However,these two parameters were significantly increased at the PCL before VF or losing 1 ∶ 1 capture compared with the PCL of 300 ms and 200 ms.Conclusion The results of the current study indicated that an increase of the ventricular dispersion of refractoriness and variation of activation cycle length could contribute to the vulnerability of VF induction.

关 键 词：动作电位 不应期 电生理 激动周期 心室颤动 

分 类 号：R541.7[医药卫生—心血管疾病]