消融犬右肺静脉脂肪垫对心房及右上肺静脉电生理特性及房颤诱发的影响

目的探讨消融右肺静脉脂肪垫对心房及右上肺静脉电生理特性及房颤诱发的影响。方法犬18只分别在颈部迷走神经未刺激和刺激的情况下,观察射频消融肺静脉脂肪垫前后心房不同部位及右上肺静脉有效不应期、房颤诱发率及房颤诱发窗口的变化。结果在刺激迷走神经的情况下,与消融前相比,消融后高位右心房有效不应期延长（P<0.05）,其余部位有效不应期无显著差异,消融后高位右心房房颤诱发率降低（P<0.01）,房颤诱发窗口变窄（P<0.05）,左心房（P<0.01）及右上肺静脉（P<0.01）房颤诱发率升高,诱发窗口增宽。同时,心房有效不应期离散度增加（P<0.01）。结论消融右肺静脉脂肪垫使高位右心房房颤诱发率降低及房颤诱发窗口变窄,却使左房、右上肺静脉房颤诱发率升高及房颤诱发窗口增宽。

Effects of radiofrequency ablation of fat pad at right pulmonary vein-atria junction on electrophysiology and atrial fibrillation induction of canine atria and the right superior pulmonary vein

AIM To investigate the effects of radiofrequency ablation (RFA) of the fat pad at the right pulmonary vein-atria junction (RPV fat pad) on electrophysiology and atrial fibrillation (AF) induction of atria and the right superior pulmonary vein (RSPV). METHODS Effective refractory period (ERP), incidence and induction window of AF of the atria and the RSPV with or without cervical vagal stimulation were examined before and after ablation of the fat pad. RESULTS RPV fat pad RFA increased only the ERP of the high right atrium (HRA) with vagal stimulation (P<0.05). RPV fat pad RFA decreased the incidence (P<0.01) and induction window(P<0.05) of AF at the HRA during vagal stimulation, while increased the incidence and induction window at the left atria (P<0.01) and the RSPV ( P<0.01). RPV fat pad RFA increased the dispersion of the atrial ERP ( P<0.01). CONCLUSION RPV fat pad RFA decreases the induction of AF at the HRA, while increases the induction at the left atria and the RSPV.