一种心脏立体电生理标测系统用于低强度迷走神经刺激术对在体大鼠心房颤动模型的研究  

A novel three-dimensional cardiac electrophysiological mapping system for comprehensive electrophysiological evaluation of murine atria in vivo with low-level stimulation of vagus nerve

作　　者：范博渊[1] 吴涛 李梦颖[1] 张维[1] 金葵花[1] 倪四峰[1] 郑强荪[1] 

机构地区：[1]第四军医大学唐都医院心内科,陕西西安710038 [2]中煤西安设计工程有限责任公司,陕西西安710054

出　　处：《中国心脏起搏与心电生理杂志》2017年第2期149-156,共8页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：国家自然科学基金资助项目(编号:31271039;81070161)

摘　　要：目的发明一种适用于大鼠的心脏立体电生理标测系统(3D-CEMS)用于全面评价自主神经功能对心房颤动(简称房颤)及心房电生理特性的影响。方法取大鼠30只,随机分为正常对照组、ACh-CaCl_2注射组、低强度迷走神经刺激(LL-VNS,能引起窦性心动过缓及房室传导延长的临界电压的10%)组。取大鼠正中线与第四肋间或心尖搏动最明显部位交点水平线开胸,充分暴露心脏视野。使用所发明的3D-CEMS标测三组大鼠高位右房、右房、低位右房、左心耳、左房、左房-左肺静脉交界处等6个部位的有效不应期(ERP)、ERP离散度(dERP)及房颤易感窗口(WOV)、总房颤易感窗口(∑WOV)。结果与正常对照组比较,ACh-CaCl_2组和LL-VNS组可显著减少6个标测部位的ERP、延长WOV、增加dERP和∑WOV。LL-VNS组可较ACh-CaC_l2组显著增加各部位的ERP、缩短WOV、减少dERP和∑WOV,对房颤产生明显的抑制作用。结论 3D-CEMS作为一套实用的心房电生理标测工具,可成功用于评价LL-VNS对大鼠心房电生理特性的影响及对房颤的抑制作用。Objective To invent a novel three-dimensional cardiac electrophysiological mapping system （3D- CEMS） for the comprehensive evaluation of autonomic nerve function on atrial fibrillation and atrial electrophysio- logical properties in rats. Methods All the 30 adult healthy SD rats were randomly assigned to three groups： blank control group, ACh-CaCl2 control group and low-level vagus nerve stimulation （LL-VNS） group. All chests were opened through a median sternotomy at the fourth intercostal space or the intercostal at the cardiac point of maximal impulse to achieve maximum exposure of heart. Using the 3D-CEMS to mapping effective refractory period （ERP） , dispersion of ERP（dERP）, window of vulnerability（WOV） and sum of WOV（SWOV） of the 6 sites in- cluding high right atria（HRA）, right atira（RA）, low right atrial（LRA）, left atrial appendage（LAA）, left atria （LA） and the junction of left atria and left pulmonary vein（.ILA-LPV） in three groups. Results Compared with control group, ERP was significantly reduced in ACh-CaC12 group and LL-VNS group ,while dERP, WOV and WOV were increased significantly, LL-VNS group, comparing ACh-CaCl2group, ERP was significantly reduced. dERP, WOV and ∑WOV were decreased obviously. Conclusion 3D-CEMS served as a useful tools for atrial elec- trophysiological mapping in rat in vivo, which can be successfully used to evaluated the effect of LL-VNS on atrial electropbysiological properties and the inhibition of atrial fibrillation in rats.

关 键 词：心血管病学 心房颤动 立体电生理标测系统 心房电生理特性 肺静脉 左房 

分 类 号：R541.75[医药卫生—心血管疾病] R331.38[医药卫生—内科学]