Marshall韧带在犬持续性心房颤动中的作用  

Role of Marshall ligament in maintaining persistent atrial fibrillation of dogs

作　　者：朱俊[1] 史加海[1] 孟旭[2] 吴信华[3] 李晖[2] 

机构地区：[1]南通大学附属医院心胸外科,江苏省226001 [2]首都医科大学附属北京安贞医院心外科 [3]南通大学附属医院外科综合实验室,江苏省226001

出　　处：《江苏医药》2015年第24期2934-2937,F0003,共5页Jiangsu Medical Journal

基　　金：江苏省六大人才高峰资助(WS-059)

摘　　要：目的探讨Marshall韧带在犬持续性心房颤动(房颤)中的作用。方法 12只犬窦性心律下予以S1-S1、S1-S2和高频神经刺激,心外膜标测记录Marshall韧带电位。爆发刺激诱发持续性房颤后记录左心房顶、左肺静脉和Marshall韧带电位。比较干预前后房颤的可诱导性和最长持续时间,并行Marshall韧带组织学检测。结果窦性心律下S1-S1刺激,可记录到Marshall韧带电位;S1-S2刺激时可记录到递减传导现象;高频神经刺激可诱发Marshall韧带远心端快速激动并诱发房颤。持续性房颤诱发后,可记录到环左心房和Marshall韧带的折返激动。Marshall韧带切除消融后,房颤可诱导性和房颤最长持续时间较干预前均下降(P<0.05)。结论 Marshall韧带在持续性房颤维持中起重要作用,通过局灶触发机制和折返机制参与持续性房颤的维持。Objective To investigate the role of Marshall ligament in maintaining persistent atrial fibrillation（AF） of dogs. Methods Twelve dogs were given S1-S1, S1-S2 and high frequency nerve stimulation in sinus rhythm. Marshall ligament was mapped epicardially. Electric potential of left pulmonary veins, biatrial roof and Marshall ligament were recorded after persistent AF induced by burst stimulation. Marshall ligament was dissected for histological evaluation. Results The characteristic electrogram of Marshall ligament and decremental conduction were recorded by S1-S1 and S1-S2 stimulations in sinus rhythm. Rapid firing in the distal part of Marshall ligament inducing AF was recorded after high frequency nerve stimulation. After persistent AF was induced with burst stimulation,the reentry activation around the left atrium and Marshall ligament was recorded. AF inducibility and duration were lower after ablation of Marshall ligament than before （P〈0. 05）. Conclusion Marshall ligament plays an important role in the maintenance of persistent AF by focal trigger and reentry mechanisms.

关 键 词：心房颤动 MARSHALL韧带 

分 类 号：R541[医药卫生—心血管疾病]