犬左上肺静脉电传导的特性(PDF)
《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]
- 期数:
- 2008年第4期
- 页码:
- 417-419，427
- 栏目:
- 基础研究
- 出版日期:
- 2008-08-20
文章信息/Info
- Title:
- The characters of electric conduction in canine left superior pulmonary veins
- Author(s):
- LIU Xiongtao; ZHENG Qiangsun; LU Yansheng; HONG Changming; HE Yong; ZHANG Luxing
- Department of Cardiology, Tangdu Hospital, Fourth Military Medical University, Xi’an 710038, Shaanxi, China
- Keywords:
- pulmonary veins; focal atrial fibrillation; conduction
- 分类号:
- R541.75
- DOI:
- -
- 文献标识码:
- A
- 摘要:
- 目的 研究肺静脉电传导的特性，探讨肺静脉异位兴奋灶诱发心房纤颤的具体机制。方法 选用25只犬,将自制的18导联环状标测电极置于左上肺静脉外膜上，从左心房、冠状窦远端、肺静脉远端采取S1S1、S1S2两种刺激方案，记录肺静脉18导联外膜标测电图。结果 肺静脉内存在类文氏和类莫氏传导阻滞和肺静脉-左心房传导速度逐渐加快电生理现象，后一现象发生在房颤启动前，导致短配对间期或短长周期的心房激动；电活动从心房向肺静脉远端传导时肺静脉各个部位激动较一致，而电活动从肺静脉远端向心房传导时肺静脉各个部位激动不一致；肺房传导时间显著长于房肺传导时间［(466±144)ms vs (178±93)ms，P<001\]。结论 正常肺静脉具有传导阻滞、传导延迟及各向异性传导的特性，有利于肺静脉内折返的形成；而肺静脉异位兴奋灶快速电活动使肺静脉和心房发生电重构，导致肺静脉-左心房传导速度逐渐加快，最终诱发出心房纤颤。
- Abstract:
- AIM To study the characters of electric conduction in pulmonary veins and then to better understand the electrophysiological mechanism of focal atrial fibrillation (FAF) originating from the pulmonary veins. METHODS Twentytwo dogs were used in this study. We placed the annular measuring electrode in the adventitia of the left superior pulmonary veins, stimulated the left atria, distal of CS and distal pulmonary veins by S1S1 bursting stimulation and S1S2 program stimulation and recorded the mapping of pulmonary veins. RESULTS Three electrophysiological phenomena were found in the LSPV, conduction blocks: Wenckebach and Mobitz, and conduction acceleration which happened just before AF. Conduction acceleration triggered the short interval and shortlong cycle of atrial activation and initiated AF. When electrical impulses propagated from LA to distal of PV, the different regions of PV agitated simultaneously. When electrical impulses propagated from distal of PV to LA, the different regions of PV did not agitate simultaneously. The conduction time from PV to LA was longer than the that from LA to PV［(466±144)ms vs (178±93)ms, P<001). CONCLUSION The electrical conduction in PV includes conduction blocks, Conduction delay and different anisotropy conduction, which caused microreentry in the PV. Sustained rapid electric activity in PV can cause PVLA conduction acceleration, which is the base of inducing AF, and thus more easily induce atrial fibrillation.
参考文献/References
［1］ Haissaguerre M, Jais P, Shah DC, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins［J］. N Engl J Med, 1998, 339(10):659-666.
［2］ Haissaguerre M, Sanders P, Hocini M, et al. Pulmonary veins in the substrate for atrial fibrillation: the “venous wave” hypothesis［J］. J Am Coll Cardiol, 2004， 43(12):2290-2292.
［3］ 刁鸿英，马长生，刘兴鹏,等. 犬慢性快速心房起搏心房颤动模型的建立［J］. 中国心脏起搏与心电生理杂志, 2001, 15(2):98-100.
［4］ Chen SA, Chen YJ, Yeh HI, et al. Pathophysiology of the pulmonary vein as an atrial fibrillation initiator［J］. Pacing Clin Electrophysiol, 2003, 26(7 Pt 2):1576-1582.
［5］ Hocini M, Ho SY, Kawara T, et al. Electrical conduction in canine pulmonary veins electrophysiological and anatomic correlation［J］. Circulation, 2002, 105(20):2442-2448.
［6］ Chen YJ, Chen SA, Chen YC, et al. Effects of rapid atrial pacing on the arrhythmogenic activity of single cardiomyocytes from pulmonary veins: implication in initiation of atrial fibrillation［J］. Circulation, 2001, 104(23):2849-2854.
［7］ Jas P, Hocini M, Macle L, et al. Distinctive electrophysiological properties of pulmonary veins in patients with atrial fibrillation［J］. Circulation, 2002, 106(19)：2479-2485.
［8］ 黄明方，许春萱，盖晓波. 心房起搏预防和治疗心房颤动［J］. 中国心脏起搏与心电生理杂志, 2004, 18(2):136-139.
备注/Memo
- 备注/Memo:
- 收稿日期：2007-09-11.基金项目：军队“十五”卫生科研基金项目资助(01MB126) 通讯作者：郑强荪，主任医师，主要从事心律失常、冠心病的基础与临床研究Email:tdxznk01@fmmu.edu.cn 作者简介：刘雄涛，主治医师，博士生Email:lxt22grm@yahoo.com.cn
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