Effect of Captopril on Membrane Currents of Ventricular Myocytes

ＥｆｆｅｃｔｏｆＣａｐｔｏｐｒｉｌｏｎＭｅｍｂｒａｎｅＣｕｒｒｅｎｔｓｏｆＶｅｎｔｒｉｃｕｌａｒＭｙｏｃｙｔｅｓＷＡＮＧＹａｎｇ－ｇａｎ（王扬淦）；ＬＵＺａｉ－ｙｉｎｇ（陆再英）（ＤｅｐａｒｔｍｅｎｔｏｆＣａｒｄｉｏｌｏｇｙ，ＴｏｎｇｊｉＨｏｓｐｉｔ...     

The Effects of Radiofrequency Catheter Ablation on the Metabolic Enzymes and Ca~（＋＋）－ATPase of Myocytes

（王扬淦）（陆再英）（熊希凯）ＴｈｅＥｆｆｅｃｔｓｏｆＲａｄｉｏｆｒｅｑｕｅｎｃｙＣａｔｈｅｔｅｒＡｂｌａｔｉｏｎｏｎｔｈｅＭｅｔａｂｏｌｉｃＥｎｚｙｍｅｓａｎｄＣａ~（＋＋）－ＡＴＰａｓｅｏｆＭｙｏｃｙｔｅｓＷＡＮＧＹａｎｇｇａｎ；ＬＵＺａｉｙｉｎ?..     

The Effect of Levobunolol Hydrochloride on the Calcium andPotassium Channels in Isolated Ventricular Myocytes of Guinea Pig

Summary The effects of levobunolol hydrochlorid (Bun) on the type L calcium channel currents (I_ca and delayed rectifier potassium channel currents (I_k) in isolated ventricular myocytes of guinea pig were studied by using patch clamp whole cell recording techniques. The results were showed that: 1) Bun caused a dosedependent decrease in I_ca and a dose-dependent increase in I_k of the ventricular myocytes. The threshold concentrations of Bun for I_ca and I_k were 10⁻⁸ mol/L and 10⁻⁷ mol/L respectively. The maximum effective concentration of Bun for both I_ca and I_k was 3 × 10⁻⁵ mol/L, and half-maximal concentration Was 3 × 10⁻⁶ mol/L; 2) I_k was blocked by 2 × 10⁻⁶mol/L tetraethylammonium (TEA). A concentration of 3 × 10⁻⁶ mol/L Bun showed a decreasing effect on the Ic as revealed by the current-voltage relationship curve, i.e., Bun caused an elevation of the curve; 3) When I_ca was blocked by 2X10⁻⁶ mol/L Isoptin (Verapamil), at a concentration of 3 × 10⁻⁶ mol/L Bun showed an increasing effect on Ik and the effect could be blocked by TEA- The above-mentioned results indicated that Bun had an inhibitory effect on I_ca and a fascilitatory effect on I_k. The results suggested that the molecular mechanisms of antihypertensive, heart rate slowing and β-receptor blocking effects of Bun might be due to decrease of I_ca and increase of I_k. This project was supported by Science Committee of Hubei Province (No. 95 JJ9-29).     

Effect of Calcium Ionophore and Calcium Channel Blockers on Immediate Hypersensitivity Reactions

ＥｆｆｅｃｔｏｆＣａｌｃｉｕｍＩｏｎｏｐｈｏｒｅａｎｄＣａｌｃｉｕｍＣｈａｎｎｅｌＢｌｏｃｋｅｒｓｏｎＩｍｍｅｄｉａｔｅＨｙｐｅｒｓｅｎｓｉｔｉｖｉｔｙＲｅａｃｔｉｏｎｓＨｕａｎｇＱｉｎｔｉａｎ（黄钦田）ＣｈｅｎＢｉｎｇｙｉｎｇ（陈丙莺）ＳｕｎＡｉｍ...     

Radiofrequency Catheter Ablation of Right-sided Accessory Pathways During Atrial Fibrillation

Atrialfibrillationisakindofarrythmiasfrequentlyseeninclinic.Itoccursnotonlyinpatientswithorganicheartdisease,butalsoofteninthosewithWolffParkinsonWhitesyndrome.Duringradiofrequencycatheterablationofaccessoryatrioventricularpath-c"ay,theonsetofatrialfibril…     

Electrophysiologic Mechanism and Radiofrequency Catheter Ablation of Incessent Atrioventricular Reentrant Tachycardi

Incessentatrioventricularreentranttachyc-ardia(IAVRT)meansatrioventricularreentranttachycardiawhichlastsmorethan24hoursandrefractorytoantiarrhythmicdrugtherapyandelectriccardioversionoroccursshortlyaftertermination.Wehavecured403patientswithtachycardiabyradiofrequencycatheterablationfromJanuary1991toOctober1996,17ofwhowereIAVRT.Inthisarticle,wewilldiscussitselectrophysiologicmechanism,itsinductiontocardiomyopathyandtheresultofradiofrequencycatheterablationtreatment.MaterialsandMethodsCli…     

Effects of Arecoline on Calcium Channel Currents and Caffeine-induced Calcium Release in Isolated Single Ventricular

The cholinergic system plays an importantrole in the control of heart rate and myocardialcontractility[1] .The inotropic and chronotropic ef-fects are partly regulated by the cytosolic Ca2 + lev-el( [Ca2 + ]i) .Muscarine receptor agonist,Arecol-ine ( Are) ,is a kind of alkaloid extracted from theseeds of areca.It had been reported that Are hadnegative inotropic and negative chronotropic effectson isolated guinea pig atria[2 ] ,but its effects oncalcium mobilization was unclear. In order to i…     

Voltage- and Use-dependent Effect of 7-chlor-benzylte-trahydropalmatine on Sodium Currents in Guinea Pig Ventricular Myocytes

7--chlor--benzyltetrahydropalmat(7CI--BTHP),aderivativeoftetrahydropalmatineextractedfrommanymedicalplantssuchasCorydalisambigua,hasexhibitedantiarrhythmicactioninvariousexperimentalmodels[IJ.Thepreviousstudysuggestedthat7--CI--BTHP,similartoquinidine,likelybelongedtoclasslaantiarrhythmicdrug["ZJ.Toobtainfurtherinformationaboutthevoltage--dependenceandkineticsof7--CI--BTHPoncardiacsodiumchannels,inthisstudy,weusedthewholecellpatch--clamptechniquetoinvestigatevoltage--anduse--dependente…     

Effects of Arecoline on Calcium Channel Currents and Caffeine—induced Calcium Release in Isolated Single Ventricular Myocyte of Guinea Pig

Summary The effects of Arecoline (Are) on calcium mobilization were investigated. In isolated single ventricular myocyte of guinea pig, patch clamp whole cell recording techniques were used to record the current of L-type calcium channel and cytosolic Ca²⁺ level (Ca²⁺i) labeled with fluorescence probe Fluo-3/AM was measured under a laser scanning confocal microscope. Results revealed that Are (3–100 μmol/L) could inhibit L-type calcium current in a concentration-dependent manner and the value of IC₅₀ was 33.73 μmol/L (n=5). In the absence of extracellular calcium, the resting levels of [Ca²⁺]i was not affected by Are (n=6,P>0.05), but pretreatment with Are (30 μmol/L) could significantly inhibit the [Ca²⁺]i elevation induced by caffeine (10 mmol/L,n=6,P<0.01). It was concluded that Are could inhibit not only calcium influx through L-type calcium channel but also calcium release from sarcoplasmic reticulum. This project was supported by a grant from Natural Sciences Foundation of China (No. 39670661).     

特发性室性心动过速的导管射频消融治疗效果

目的 评价导管射频消融(radiofrequency catheter ablation,RFCA)对特发性室速(idiopathic ventricular tachy-cardia,IVT)的治疗效果以及心电图对消融靶点的定位价值.方法 对126例特发性室速患者的电生理资料及RFCA治疗效果进行回顾性分析.多数患者采用激动顺序标测,射频能量采用温控法(60～65℃).结果 126例患者中右室流出道(right ventricular outflow tract,RVOT)IVT 62例、左后间隔IVT 43例,其他部位IVT 21例.本组RFCA的总成功率为87.3%,RVOT-IVT和左后间隔IVT的成功率显著高于其他部位IVT(96.8%和90.7% vs 52.4%,P<0.05).本组8例患者存在发作性晕厥(发作的R-R间期230～260 ms),其中4例合并房室结双径路、2例合并隐匿性房室旁道、2例合并多形性室速.随访6个月至10年,复发9例(复发率为8.2%),均再次RFCA成功.合并心动过速性心肌病者6例,术后3个月心脏大小与心功能均恢复正常.结论 采用激动顺序标测法RFCA治疗IVT成功率高;室速发作时体表心电图对绝大多数室速起源具有定位价值;部分室速可能合并房室旁道或房室结双径路.     

The effects of radiofrequency catheter ablation on the metabolic enzymes and Ca++-ATPase of myocytes

Summary Using histochemical technique, the effects of radiofrequency catheter ablation (RFCA) on the activities of LDH, SDH, CCO, and Ca⁺⁺-ATPase of guinea-pig ventricular myocytes were examined. The histological changes were observed for comparison. Radiofrequency energy (500 kHz) delivered was 20 WX 10 s. The results were as follows: RFCA resulted in significant impairments in all the four kinds of enzymes but without statistical differences in the areas involved in this energy level. No statistically significant difference was found between the ranges of enzymatic damages and areas of pathological lesions. These findings showed a consistency in areas of the histological and histochemical lesions resulted from RFCA.     

射频消融术治疗室上性心动过速78例

目的：总结78例射频消融术(RRCA)治疗室上性心动过速(SVT)临床资料。方珐：应用RFCA技术治疗难治性SVT。结果：房室折返性心动过速(AVRT)52例，共54条旁路消融成功49条，成功率为90．7％。其中左侧旁路成功率(97．6％)明显高于右侧(66．6％)。房室结折返性心动过速(AVNRT)26例，仅1例失败，成功率为96．1％。78例总成功率为92．5％。本组无1例严重并发症。随访2～42个月，5例复发，经再次消融成功。结论：RFCA为治疗SVT安全而有效的方法，靶点标测、消融功率和时间的控制县成功的关键．     

CARTO射频消融治疗非器质性室性心律失常的心理护理干预

目的:探讨CARTO射频消融治疗非器质性室性心律失常的心理护理干预效果。方法:选择87例非器质性室性心律失常患者,随机分为观察组和对照组。对照组患者给予常规护理干预,观察组患者在常规护理基础上给予加强心理护理和健康教育。评定两组患者护理干预前和护理干预后焦虑抑郁情绪,调查患者对该手术的接受情况。结果:观察组干预后焦虑抑郁情绪评分结果低于对照组,差异有统计学意义(P<0.05)。观察组患者中愿意接受手术治疗所占比例高于对照组,差异有统计学意义(P<0.05)。结论:心理护理和健康教育有助于CARTO射频消融治疗非器质性室性心律失常,护理效果显著。     

射频消融对豚鼠心室肌细胞钙离子流的影响

采用全细胞膜片钳技术研究了射频消融（ＲＦＣＡ）对豚鼠心室肌细胞钙离子流（ＩＣａ）的影响。结果发现，在２０Ｗ×１０ｓ能量下，ＲＦＣＡ明显减小ＩＣａ，其影响范围达消融点外１．２ｃｍ以上。而在该能量下，ＲＦＣＡ所造成的组织学损伤范围仅为０．４１±０．１１ｃｍ。提示ＲＦＣＡ除了热效应引起组织坏死外，并在更大的范围内影响了细胞膜离子流。这一发现为阐明ＲＦＣＡ组织损伤范围小而疗效高的机理提供了初步的实验依据。     

射频消融治疗阵发性室上性心动过速复发原因分析

目的：分析阵发性室上性心动过速患者行射频消融术（RFCA）后复发的原因，探讨降低RFCA复发的方法。方法：128例阵发性室上性心动过速患者，行RFCA治疗，术后每3－6个月随访1次，随访4－70个月。结果：128例患者中，复发10例，总复发率7．81％，其中房室结折返性心运过速复发率为7．89％，左侧房室旁路介导心运过速复发率5．56％，右侧旁路介导心动过速复发率16．67％。行射频消融术前70例患者中复发率11．43％，后58例复发率3．45％。结论：精确的靶点标测、熟练的操作技巧以及消融方式的正确运用是降低RFCA复发率的关键。     

房性心动过速电生理特点及消融治疗

目的　报道 4 2例房性心动过速 (AT)电生理特点及消融治疗。方法　 4 2例患者均行电生理检查 ,心动过速能被心房快速起搏及心房早搏刺激终止 ,心室起搏时无室房传导。对起源于上腔静脉和左下肺静脉 5例房性心律失常患者 ,分别采用局灶点消融和消融电隔离方法终止心动过速。结果　 5例房性心律失常病人 ,采用局灶消融和电隔离消融分别有效终止房性心动过速。AT病人均采用激动标测并结合拖带或隐匿拖带寻找消融靶点 ,靶点局部电位较体表心电图P’波提前 30～ 6 0ms以上 ,结合机械阻断等选择靶点可提高成功率 ,选择双大头标测能缩短手术时间 ,AT的机制不同对消融的成功无影响。结论　起源于上腔静脉和左下肺静脉的房性心律失常 ,射频消融治疗有良好的临床效果 ,由于心动过速造成心脏扩大 ,成功消融治疗后心脏可恢复正常。     

70例室性心律失常导管射频消融治疗临床分析

目的分析导管射频消融治疗室性心律失常患者的临床疗效。方法回顾我院于2010年6月-2011年6月间诊治室性心律失常患者70例,随机分为两组。对照组采用常规的导管射频消融术,单导管消融组只采用单导管射频消融术。结果单导管消融组治疗后消融靶点部位、并发症发生率、消融成功比例、随访心律失常复发率与对照组差异无统计学意义（P〉0．05）;两组患者与治疗前比较,治疗后每日早搏次数显著增加,具有统计学意义（P〈0．05）。结论采用单导管消融有利于减轻室性心律失常患者的痛苦,临床疗效良好,值得推广。     

射频消融治疗频发室性早搏对左室功能及其结构的影响

目的 探讨射频消融治疗频发室性早搏（室早）对左室功能及其结构的影响。 方法 收集2006年1月至2010年12月成功行射频消融治疗的频发室早病例56例,同期随访未予射频消融治疗的频发室早病例42例。比较不同处理前、后室早数、超声心动图LVEF、LVEDD、LVESD、IVSd、LVPWd各参数的变化。 结果 ①与非消融组比较,消融组射频消融治疗后,室早总数明显减少（17813±1542个/24h）vs（125±113个/24h）,P<0.01;超声心动图[LVEDD（48.9±3.8）vs（44.1±4.0）,P<0.05;LVESD（30.1±4.2）vs（27±3.7）,P<0.05;IVSd（8.5±0.8）vs（7.5±0.8）,P<0.05;LVPWd（8.5±0.9）vs（7.5±0.8）,P<0.05]各项参数差异有显著性;LVEF[（0.64±0.08）vs (0.72±0.06),P<0.05]显著提高。②与术前比较,射频消融治疗后,室早总数由术前的（23662±12559个/24h）减少为（125±113个/24h）,P<0.01,患者胸闷、心悸症状缓解,超声心动图[LVEDD（50.6±5.4）vs（44.1±4.0）,P<0.05;LVESD（32.1±5.3）vs（27±3.7）,P<0.05;IVSd（8.8±1.1）vs（7.5±0.8）,P<0.05;LVPWd（8.7±1.1）vs（7.5±0.8）,P<0.05]各项参数明显缩小;LVEF[（0.64±0.09）vs (0.72±0.06),P<0.05]显著提高。 结论 射频消融可有效改善频发室早引起的心脏结构重构和功能减退,缓解患者不适症状。     

舒芬太尼在经导管射频消融术中镇静和镇痛的研究

目的 评价舒芬太尼对经导管射频消融术心房颤动患者的镇静和镇痛效果.方法 60例接受经导管射频消融治疗的房颤患者,随机分为两组:舒芬太尼组(S组)和芬太尼组(F组).消融前10min静脉注射咪唑安定0.05mg/kg.消融前5min,S组给予负荷量舒芬太尼0.1μg/kg,随后持续静脉注射舒芬太尼0.1μg/(kg·h);F组给予负荷量芬太尼1μg/kg,随后持续静脉注射芬太尼1μg/(kg·h).术中患者疼痛时,S组增加舒芬太尼至0.2μg/(kg·h);F组增加芬太尼至2μg/(kg·h),若疼痛不能缓解,则给予咪唑安定1mg.观察两组各时点MAP、HR、KR、SpO2,视觉模拟疼痛评分(VAS)、镇静评分(OAA/S评分),咪唑安定、芬太尼或舒芬太尼用药情况,停药后清醒时间及术后患者恶心、呕吐、头晕情况、遗忘情况和满意度.结果 在T2、T3时s组OAA/S评分迭2分的例数明显多于F组,VAS明显小于F组(P<0.05).术中咪唑安定和阿片药总用量S组较F组少(P<0.05).S组和F组各有2例和1例出现轻微的呼吸抑制,不良反应发生率差异无统计学意义.结论 舒芬太尼可以安全有效用于经导管射频消融术中镇静和镇痛.