局灶性心房颤动模型的建立及其射频消融

建立一种稳定的局灶性心房颤动 (简称房颤 )的动物模型以探索其电生理特点及射频消融方法与安全性。选用 18只犬开胸直视下以乌头碱在心脏局部肌注加猝发电刺激建立模型。观察房颤射频消融前后的病理、生理、生化及房颤诱发率的变化 ,以及有效靶点的电生理特点。结果 :①所有犬均能以单次用药加猝发刺激诱发房颤 (诱发率 10 0 %)。②消融组犬在电生理标测指导下行单线射频消融 ,消融前房颤持续时间 94 2± 4 80s,消融后房颤诱发率为 13 .8%,持续时间为 7.3± 6.8s ,与消融前比较差异有统计学意义 (P <0 .0 1)。③消融前后窦性心率 ( 163 .9±2 0 .8次 /分vs 15 8.4± 2 3 .3次 /分 )、校正窦房结恢复时间 ( 89.0± 3 9.6msvs 93 .9± 3 8.0ms)、心房有效不应期 ( 14 7.3± 2 0 .9msvs14 0 .3± 18.3ms)及血清磷酸肌酸激酶 ( 5 3 0 .5± 2 0 4 .7U/Lvs 4 73 .5± 2 2 6.1U/L) ,均无明显变化 (P均 >0 .0 5 )。结论 :应用乌头碱制备局灶性房颤方法简单、诱发率高。电生理标测指导下局部消融可终止局灶性房颤。结果初步提示此法能以较少的损伤达到治疗目的 ,是较安全的 ,有一定的临床价值。

Establishment of A Canine Focal Atrial Fibrillation Model and Its Radiofrequency Ablation

.The aim of the study is to establish a focal canine atrial fibrillation(AF) model for the study of its electrophysiology characteristic and finding a easier and more effective therapy by radiofrequency ablation.The model was established with focal injection of aconitine and burst stimulate.Radiofrequency energy was delivered through the epicardial with the guide of mapping in 13 canine,and 5 canine served as control group.Inducibility of AF and duraion of AF was significantly lower after the ablation (13.8% vs 100%,942±480 ms vs 7.3±6.8 ms,P<0.01).No significant difference was found in atrial effective refractiory periods,corrected sinoatrial node recovery time,creatine kinase before and after ablation (147.3±20.9 ms vs 140.3±18.3 ms,89.0±39.6 ms vs 93.9±28.0 ms,530.5±204.7 U/L vs 473.5±226.1 U/L,P>0.05).Conclusion:The results indicate that this model of atrial fibrilltion is easier with high inducibility,and with the focal atrial fibrilltion,ablation with the guide of mapping is effective and practicable.