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|本期目录/Table of Contents|

肺静脉起搏时犬房间隔激动时序特征的研究(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2001年第4期
页码:
303-305
栏目:
论著
出版日期:
2001-07-01

文章信息/Info

Title:
The activation patterns of the canine atrial seplum during pacing from the pulmonary veins
作者:
赵玉; 郑强荪、杜日映
第四军医大学唐都医院心内科，陕西西安7l0038
Author(s):
ZHAO Yu; ZHENG Qiang-sun; Du Ri-ying
Department of Cardiology，Tangdu Hospital，Fourth Military Medical University，Xi'an Shaanxi 710038．China
关键词:
心房; 房间隔; 肺静脉; 传导; 标测; 心房颤动; 犬
Keywords:
atrium ; atrial septum ; pulmonary vein; conduction; mapping; atrial fibrillation; dog
分类号:
R541.75
DOI:
-
文献标识码:
A
摘要:
目的 研究肺静脉起搏时犬房间隔激动的时序特征,进一步了解起源于肺静脉的异位搏动引发心房颤动的电生理机制. 方法 选用5只犬，放置电生理标测导管于Bachmann氏束(BB)右房间隔侧、卵园窝(FO)及冠状窦(cs) 同步记录BB、FO丑CS近端(CSp)处心内电图:作左上肺静脉(LSPV) 右下肺静脉(JJIPV)、右上肺静脉(RSPV)及右下肺静脉(RIPV)开口处起搏，观察房间隔激动的时序特征.结果：LSPV起搏时BB及FO为最早激动点．刺激波至CSp的传导时间与FO及BB处相比，虽未达到统汁学差异，但呈延长的倾向(40：k12ms vs 29土7ms及29土5ms)。LIPV起搏时CSp，FO及BB处几乎同时激动，刺激波至该三处的激动时间无明显差别(29±12，28±8及33土10ms) RSPV起搏时BB及FO为最早激动 ．刺激波至FO及BB的时间短于至CSp的时间(26土6ms及24土11 ms vs 40±10ms，均P
Abstract:
AIM T0 better understand the electrophysiologjcal mechanism of atrial fibrillation(AF)initiated by ectopic beats originated from the pulmonary veins(PV)by studying the activation patterns of the canine atrial septum during pacing from PV．METIIODS Five dogs were included．Three muhielectrodes were placed in the high anterior septum，the presumed insertion of Baehmann's bundle(BB)，the fossa ovalis(FO)and the coronary sinus(CS)．Simultaneous bipolar recordings were obtained from BB，PO and the proximal CS(CSp)．The activation sequences were analyzed during PV pacing．RESULTS During the left superior PV pacing,the earliest activation was near BB and FO ．The mean activation times from stimulus to BB and FO were not significantly different from that to CSp，but that had a tendency of decrease(29士7，29士15 and 40士12ms)．During the left inferior PV pacing，CSp，FO and BB were almost activated simultaneously．The mean activation times from stimulus to these three sites were not significantly different(29士l2，28± 8 and 33± 10 ms)．During right superior PV pacing，BB and FO were the earliest activation sites．The mean activation times from stimulus to BI3 and FO were shorter than that to CSp(26士6 ms versus 4O± 10 ms．P< 0．05；24士l1 ms versus 4010 ms，P< 0．05)．During right inferior PV pacing，BB．FO and CSp were almost activated simultaneously．The mean activation times from stimulus to these three sites were not significantly different(28士15 ms，26士5 ms and 29士14 ms)．The total septal activation time during left inferior pacing PV was shorter than that during the sinus rhythm (9士10 ms versus 29± 9 ms，P< O．05)．The total septal activation time was not significantly different during the inferior PV pacing compared with the superior PV pacing(1l土9ms and 2l士10 ms)，but it demonstrated a tendency of decrease．CONCLUSION The superior PV pacing demonstrated that BB and FO are preferential pathways of transseptal conduction．The inferior PV pacing showed that BB，FO and CSp are almost activated simultaneously and the total septal activation time is retatively short．The results of this study may lay a foundation for better understanding the electrophyslological mechamism of AF initiated by ectopic beats originating from PV．

参考文献/References

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[3] Sun H,Velipasaoglu EO．Wu DE，et al．Simultaneous multisite mapping of the right and left atrial septum in the canine intact bearing heart[J] Circulation．1999,l00：3l2．

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[6]Chen SA，Hsieh MH，Tai CT，et al．Initiation atrial fibrillation by ectopic beats originating from the pulmonary veins: Electrophysiological characteristics ,pharmacological responses,and effect of radiofrequency ablation[J]. Circulation, 1999，lO0:1879．

[7]杜日映．导管射频清融治疗心房颤动的希望何在[J]?中国心脏起搏与电生理杂志,2001，15：73.

[8]Yu WC，Chen SA,Tai CT，et al. Effects of different atrial pacing modes on atrial electrophysiology：lmplicating the mechanism of biatrial pacing in prevention of atrial fibrillation[J]．Circulation．1997，96：2992．

备注/Memo

备注/Memo:
收稿日期：2001-01-08.基金项目：国家自然科学基金(NO．39770327)
更新日期/Last Update: 2001-07-01