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犬Marshall韧带的电生理学特点及其形态结构观察(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2001年第2期
页码:
95-97
栏目:
论著
出版日期:
2001-03-01

文章信息/Info

Title:
Electrophysiological characteristic and morphologic observation of ligament of Marshall in dogs
作者:
王斌1; 杜日映1; 郑强荪1; 赵玉1 ; 凌凤东2 ; 马福成3
1. 第四军医大学唐都医院心内科，陕西西安710038；2. 西安交通大学医学院解剖学教研室； 3. 第四军医大学西京医院病理科
Author(s):
WANG Bin1 ; DU Ri-ying1 ; ZHENG Qiang-sun 1; ZHAO Yu 1; LING Feng-dong2 ; Ma Fu-cheng3
1．Department of Cardiology，Tangdu Hospital， Fourth Military Medical University， Xi'an shaanxi 710038．China
关键词:
心房颤动; 局灶性; Marshall韧带; 射频消融; 狗
Keywords:
atrial fibrillation; focal; ligament of Marshall; radiofrequency catheter ablation; dogs
分类号:
R541.75
DOI:
-
文献标识码:
A
摘要:
目的 观察Marshall韧带(LOM）的电生理学特点及其组织形态，探讨LOM 在局灶性房颤发病机制中的地位。方法 选用健康犬8只，放置心内电般导管和心外膜电极，同步记录高位右房(HRA)，左心耳(LADE)，LOM 的电活动。射频消融LOM 靠近冠状窦的部位。比较消融前后HRA—LAA间期，HRA—LAM(左房)间期，HRA—LOM 间期，LAM—LOM 间期 切取LOM，进行组织学观察。结果 窦性心律时。在LOM 上可以记录到双电位，前者是LAM电位，后者是LOM 电位．消融LOM靠近冠状窦的部位，LOM 电位消失，消融前后，HRA—LAA间期、HRA-LAM间期对比无显著性差异(P>0．05)。组织切片显示LOM 内含有心肌组织，与深层左房肌被脂肪层隔离，脂肪层内含有大量的神经组织．结论 LOM 电位是LOM 内心肌组织产生的，LOM 可能是局灶性房颤的起源部位之一。射频消融LOM靠近冠状窦的部位对左右房间传导无影响。对起源于LOM 的局灶性房颤，消融这一部位可能有效。
Abstract:
AIM To investigate the roles of ligament of Marshall in mechanism of focat atrial fibrillation by studying the electrophysiological characteristic and morphology.METIIODS Eight healthy dogs were chosed．Epicardial electrodes and endocardial electrodes were placed．The electroactivities were recorded at high right atrium(HRA)，left atrial appendage(LAA)，ligament of marsha11(LOM) synchronously．The part of ligament of Marshall near coronary sinus(CS)was ablated． HRA—LAA internal，HRA—left atrial muscle(LAM ) internal，HRA—L0M internal，LAM—LOM internal were compared before and after ablation．LOMs were cut off，studied with histology method．RESULTS Double electrical potentials(LAM potential and LOM potentia1)were recorded on ligament of Marshall in sinus rhythm．LOM potential disappeared after ablating the part of LOM near CS．HRA—LAA internal and HRA—LAM internal didn't change apparently after ablation．Morphologic observation suggested that there was cardiac muscle in the ligament of Marsha11．There were a lot of nervous tissues near the ligament．CONCLUSION LOM potential originates from the cardiac muscle in LOM ．Ablation on the part of LOM near the CS doesn't influence conduction between left and right atrium．Some focal atrial fibrillations maybe result from LOM ．It is possible to ablate the LOM to cure the focal atrial fibrillation by eliminating the L0M potentia1．

参考文献/References

[1]Kopecky SL,Gersh BI,McGoon MD，et al.The nature history of line atrial fibrillation，A population-based study over three decades[J]．N Engl J Med．1987,377:669.

[2]Haissaguerre M,Jais P，Shah DC,et al.Spontaneous initiation of atriaL fibrillation hy ectopic beats originating in the pulmonary veins[J]. N Engl J Med．1898,339:659．

[3]杜日映，薛玉生，王毅，等．导管射频肺静脉口环状消融治疗局灶性房颤[J].刀中国心脏起搏与心电生理杂志．2000，l4:23．

[4]Hwang C，Karagueuzisn HS,Chen PS. Idiopathic paroxysmal atrial fibrillation induced bv a focal discharge mechanism in the left superior pulmonary vein: possible roles of the ligament of Marshall[J]．J Cardiovasc Electrophysiol．1999,10：636.

[5]Wagner ML,Lazzara R,Weics RM,et a1．Specialized conducting fibers in the interatrial band[J]．Circ Res．1966，18:502．

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[7]Doshi RN,Wu TJ,Yashima M,et a1．Relation between ligement of Marshall and adrenergic atrial tachyarrythmia[J]．Circulation．1999,100:876.

[8]Hwang C,Wu TJ，Doshi RN,et al．Vein of Marshall cannulation for the analysis of electrical activity in patients with focal atrial fibrillation[J]．Circulation.2000,101：1503.

备注/Memo

备注/Memo:
收稿日期：2000-08-31.基金项目：国家自然科学基金(No 39770327)
更新日期/Last Update: 2001-03-01