山羊房颤模型中左心房与肺静脉外膜碎裂电位的动态比较  

Dynamic comparisons of epicardial electrograms between the left atrium and pulmonary veins in atrial fibrillation in goat model

作　　者：李健[1] 时向民[1] 郭红阳[1] 林琨[1] 国建萍[1] 王玉堂[1] 单兆亮[1] LI Jian;SHI Xiang-min;GUO Hong-yang;LIN Kun;GUO Jian-ping;WANG Yu-tang;SHAN Zhao-liang(Department of Cardiology,1 st Medical Center,General Hospital of PLA,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心心内科,北京100853

出　　处：《中国应用生理学杂志》2021年第3期235-239,共5页Chinese Journal of Applied Physiology

基　　金：军队保健专项课题(17BJZ08)。

摘　　要：目的:比较在持续性房颤发生、发展过程中,房颤模型山羊左心房与肺静脉外膜碎裂电位(CFAEs)的变化,以期探讨肺静脉外膜碎裂电位(CFAEs)在持续性房颤中的作用。方法:选取10只雌性山羊,使用左心房快速刺激,发送输出电压为6 V、周长为20 ms的脉冲1 s,间隔2 s后重复发放,以此方法建立持续性房颤模型(房颤持续>24 h),平均刺激时间为(9.5±2.3)d。在整个房颤发生、发展过程中,记录并比较刺激前后左心房及肺静脉外膜CFAEs的动态变化。结果:随着刺激时间延长,心房不应期(AERP)逐渐缩短,房颤持续时间逐渐延长,左心房及肺静脉外膜的CFAEs逐渐增多,肺静脉外膜CFAEs的比例始终多于左心房。当房颤持续24 h,肺静脉外膜CFAEs几乎持续存在(房颤初发与房颤持续24 h相比,2.7%±3.6%vs 92.6%±6.4%,P<0.05),肺静脉外膜CFAEs比例明显高于左心房(P<0.05)。结论:心外膜CFAEs具有位置特异性,与电重构相关联。房颤发生发展中心外膜CFAEs逐渐增多,可能在房颤的维持中起重要作用。Objective:To compare epicardial electrograms between the left atrium(LA)and pulmonary veins(PVs)dynamically at development of persistent atrial fibrillation(AF)in goats PVs.Methods:Ten female goats were instrumented with electrodes at the LA and left side PV.Sustained AF(>24 h)was induced in the goat by rapid intermittent left atrial pacing for(9.5±2.3)days at a pacing interval of 20 ms for 1 s with a maximum output of 6.0 V,followed by a 2-s period without pacing.Characteristics of PVs and LA epicardial electrograms were analyzed in the development of AF.Results:With prolonged stimulation,the duration of AF was prolonged,complex fractionated atrial electrograms(CFAEs)in LA and was increased gradually,PVs had more CFAEs than LA all the time.When induced AF lasted for more than 24 h,CFAEs in PVs became sustained approximately(2.7%±3.6%vs 92.6%±6.4%,at onset of AF vs AF lasted for more than 24 h,P<0.05),and the ratio of CFAEs in PVs was more than that in LA(92.6%±6.4%vs 72.8%±5.3%,P<0.05).Conclusion:The epicardial CFAEs are in specific area,which increase along with electrical remodeling.The epicardial CFAEs may play an important role in the maintenance of AF in this model.

关 键 词：心房纤颤 心外膜电位 左心房 肺静脉 山羊 

分 类 号：R-332[医药卫生]