肺静脉脂肪垫酒精消融治疗犬心房颤动的实验研究

摘要

目的 探讨肺静脉脂肪垫酒精消融对左心房-肺静脉交界触发的局灶性房颤治疗的有效性.方法 成年杂种犬10只,通过脂肪垫静注氯化乙酰胆碱(Ach)+心房短阵快速电刺激(burst)诱发出左心房-肺静脉交界触发的局灶性房颤,并给予心内电生理监测.比较房颤模型建立前后及肺静脉脂肪垫酒精消融前、后,左右心房不应期、肺静脉-左房交界处不应期以及房颤诱发率.结果 所有犬均能诱发房颤,左房和肺静脉-左房交界处不应期均较基线(窦性心律时)显著缩短(P＜0.0001),右房无明显变化(P=0.343).酒精消融后房颤诱发率显著降低(P＜0.003);肺静脉-左房交界处不应期显著增加(P=0.037);左房及右房不应期无变化(P=0.343).结论 肺静脉脂肪垫酒精消融对左心房-肺静脉交界触发的局灶性房颤治疗有效.%Objective To investigate the effectiveness of alcohol ahlation of pulmonary vein fat pad on treating the focal atrial fibrillation ( AF) triggered from the junction of the left atrium - pulmonary vein. Methods Ten adult mongrel dogs were included in this study. Focal AF which was from the junction of the left atrium - pulmonary vein was induced by Ach injection and burst stimulation in the fat pad, and was given electrophysiological monitoring. Alcohol ablation was performed after Ach injection.The effective refractory periods( ERPs) of the left atrium , the right atrium and the pulmonary vein - left atrium junction and the induction rate of AF were mesured before and after the alcohol ablation and the establishment of AF model. Results AF could be inducecl in all the dogs. Their ERPs of the left atrium and the pulmonary vein-left atrium junction in the condition of AF were shorter significantly than those in the condition of sinus rhythm ( P ＜ 0. 0001) ;. There was no significant change of the ERPs in the right atrium(P =0. 343). Compared with those before the alcohol ablation, the induction rate of AF was decreased significantly ( P ＜ 0. 003) and the ERP of the pulmonary vein-left atrium junction was longer ( P = 0. 037) after the alcohol ablation. There was no significant change of the ERPs in the left and the right atrium before and after the alcohol ablation ( P = 0. 343 ) . Conclusion The focal AF triggered from the junction of the left atrium - pulmonary vein could he eliminated effectively by the alcohol ablation of pulmonary vein fat pad.