低强度自主神经节刺激对心房电生理特性的影响  

The effects of six-hour low-level ganglionated plexi stimulation on atrial electrophysiology

作　　者：吴柳[1] 鲁志兵[1] 何勃[1] 何文博[1] 黄兵[1] 崔博[1] 胡笑容[1] 江洪[1] 

机构地区：[1]武汉大学人民医院心内科,武汉430060

出　　处：《中华心律失常学杂志》2011年第6期446-449,共4页Chinese Journal of Cardiac Arrhythmias

基　　金：国家自然科学基金（81070143）武汉大学2008年博士研究生自主科研项目（20083020101000062）：中央高校基本科研业务费专项资金、武汉大学自主科研项目（4101024）：教育部博士点志项基金新教师基金（20100141120072）

摘　　要：目的研究6h低强度自主神经节（GP）刺激对犬心房电生理性质的影响。方法22只成年杂种犬开胸暴露心脏，在左右心房、左右心耳及肺静脉缝置多极电极导管用以记录和刺激。实验组16只犬同时在左上GP及右前GP予以6h低强度高频刺激（0．1—1．0V），使心率下降10％。对照组6只犬在心房远离GP处给于同样6h低强度刺激（无心房激动）。刺激前、刺激开始时及6h刺激后测定各部位有效不应期（ERP）及心房颤动（房颤）易颤窗口（WOV）。结果在实验组犬中，GP刺激开始时ERP及WOV较刺激前差异均无统计学意义，GP刺激6h后各部位ERP均显著缩短，总WOV显著增加（127＋35对0对0，P〈O．05）。对照组中，刺激前、刺激开始时及刺激6h后ERP及WOV（3±2对0对0，P〉0．05）差异均无统计学意义。结论6h低强度GP刺激可致心房电生理性质显著改变，并有利于房颤发生，提示长期低强度自主神经系统激活可形成有利于房颤发生的电生理基质。Objective To investigate the effects of 6 h low-level ganglionated plexi （GP） stimulation on atrial electrophysiology. Methods In twenty-two anesthetized open-chest dogs, multi-electrode catheters were sutured to multiple sites to allow recording and stimulating at the left atrial appendage,left atrium,left su- perior pulmonary vein （PV）. Similar electrode catheters were attached to right atrial appendage, right atrimn and right anterior PV. Electrodes on the anterior right GP（ARGP） and superior left GP（SLGP） allowed six-hour low level GP stimulation （LL-GPS） （0. 1 - 1.0 V） inducing a 10% decrease in sinus rate in 16 dogs. The similar low-level stimulation （without myocardial capture） was delivered to the myocardium remote from GP for 6 h in another 6 dogs as control. The atrial effective refractory period （ERP） and the window of vulnerabil- ity （WOV） for AF were measured at all sites at baseline, at the beginning as well as at the end of the simula- tion. Results At the beginning of LL-GPS, ERP and WOV did not show significant alterations compared to the baseline values at any site. After 6 h of LL-GPS, ERP was significantly shortened at each site （P〈0.05 for all） and the total WOV was significantly increased （127＋35 vs 0 vs 0 ,P〈0.05） compared to the values obtained at the beginning of 6 h-LL-GPS. The similar 6 h of low level stimulation delivered to the myocardium remote from GP in another six dogs did not significantly change the ERP and WOV （ 3-＋2 vs 0 vs O, P〉0.05 ） at any site compared to the values obtained at baseline and at the beginning of the stimulation. Conclusions Six-hour low-level GP stimulation induced significant changes in atrial electrophysiology and facilitated the initiation of AF, indicating that long-term low level autonomic activation would form electrophys- iological substrate for AF.

关 键 词：心房颤动 自主神经系统 自主神经节 

分 类 号：R541.7[医药卫生—心血管疾病]