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左房起搏时犬房间隔激动顺序的电生理标测研究(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2002年第2期
页码:
97-99
栏目:
实验研究
出版日期:
2002-03-01

文章信息/Info

Title:
Electrophysiological mapping of the excitatory sequence in the canine atrial septum during pacing from the left atrium
作者:
赵　玉;  杜日映;  郑强荪
第四军医大学唐都医院心内科, 陕西 西安 710038
Author(s):
ZHAO Yu; DU Ri-ying ;  ZHENG Qiang-sun
Department of Cardiology, Tangdu Hospital, Fourth Military Medical University, Xi’an Shaanxi
关键词:
心房;  房间隔;  传导;  标测;  心房颤动;  犬
Keywords:
atrium ;  atrial septum ;  conduction; mapping;  atrial fibrillation;  dog
分类号:
R541.75
DOI:
-
文献标识码:
A
摘要:
目的 研究左房起搏时犬房间隔激动的电生理特征, 进一步了解房间传导在心房颤动发病机制中的作用。方法 选用5只犬, 放置电生理标测导管于Bachmann 束(BB) 右房间隔侧。卵园窝(FO) 及冠状窦(CS)。同步记录BB,FO 及CS 近端(CSp) 处心内电图, 作CS 远端(CSd) 及左心耳(LAA) 处起搏, 观察房间隔激动顺序变化。结果 CSd起搏时CSp 为房间隔最早激动点, 刺激波至CSp 的激动时间短于至FO 及BB 处的激动时间(17±10vs 37±15ms及43±16ms, 均P<0.05)。LAA 起搏时BB 为最早激动点, 刺激波至BB 处短于至FO 的激动时间(15±5vs 27±8ms, P<0.05) 且至FO 处短于至CSp 处的激动时间(27±8vs 42±8ms, P<0.05)。CSd 及LAA 起搏时的房间隔激动时间与窦性心律时相比无明显变化(28±11 ms 及27±4ms vs 29±9ms)。结论 CSd 及LAA 起搏时房间隔激动顺序的标测表明经房间隔的传导存在优势传导径路。CSd 起搏时CS 为优势传导径路,LAA 起搏时BB 为优势传导径路。本研究结果为进一步了解房间传导在房颤发生中的作用提供了理论依据。
Abstract:
AIM To better understand the role of interatrial electrical connections in mechanism of atrial fibrillation (AF) by studying the electrophysiological characteristic of atrial septal activation during pacing from the left atrium. METHODS Five dogs were included. Three multielectrodes were placed in the high anterior septum,the presumed insertion of Bachmann's bundle(BB),the fossa ovalis(FO)and the coronary sinus(CS). Simultaneous bipolar recordings were obtained from BB.FO and the proximal CS(CSp). The activation sequences were analyzed during left atrial pacing. RESULTS During CSd pacing,the earliest atrial septal activation was near CSp. The mean activation time from stimulus to CSp was shorter than that to FO and BB(17±10 ms versus 37±15 ms,P<0.05;17±10 ms versus 43±16 ms,P<0.05). During LAA pacing,the earliest activation was near BB.The mean activation time from stimulus to BB was 15±5 ms compared with 27±8 ms to FO(P<0.05)and 42±8 ms to CSp(P<0.05).The total septal activation times were not significantly different during CSp and LAA pacing compared with sinus rhythm(28±11 ms and 27±4 ms versus 29±9 ms). CONCLUSION Activation mapping during CSd and LAA pacing demonstrated that preferential routes of transseptal conduction exist. During CSd pacing,CS is the preferential conduction pathway.During LAA pacing,BB is the preferential conduction pathway.These findings may lay a foundation for a better understanding the role of interatrial connections in the initiation and maintenance of AF.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2001-01-18.基金项目: 国家自然科学基金(No.39770327)
更新日期/Last Update: 2002-03-01