兔右冠状动脉急性闭塞与再灌注时心律失常的发生与演变

为观察右冠状动脉急性闭塞时与再灌注时心律失常的发生及演变 ,取家兔 90只随机分为对照组、缺血 1 0 ,30 ,60 ,1 2 0min组及缺血 1 0 ,30 ,60 ,1 2 0min再灌注 4h组 ,每组 1 0只。通过结扎及放松右冠状动脉起始部建立缺血再灌注损伤模型 ,同步记录体表心电图及His束电图 ,观察AA、AH、HV间期的变化及心律失常发生与演变情况。结果 :①对照组各时相点AA、AH、HV间期比较均无显著差异 (P >0 .0 5)。②实验组 80只兔中 ,结扎右冠状动脉后 3只 (3 .75 % )发生心室颤动、67只 (83 .75 % )发生不同程度的房室阻滞 ,51只 (63 .75 % )发生窦性及房性心律失常 ,54只 (占 67.5 % )的AA间期延长在 40ms以上。③缺血再灌注组 40只兔 ,2 6只于缺血期发生窦性或房性心律失常 ,其中 1 5只于再灌注后 2 0min内恢复正常 ;缺血时发生房室阻滞的 7只兔均于再灌注后 30min内逐渐恢复正常。另有 3只发生了新的心律失常。④缺血期出现AA、AH间期延长的兔 ,均于再灌注后短期内迅速缩短 ,并逐渐恢复至对照组水平 ;但缺血 1 2 0min再灌注组 ,则随着再灌注时间进一步延长 ,AA及HV间期再次延长。结论 :右冠状动脉急性闭塞可引起兔窦房结放电频率减慢及房室传导障碍 ,再灌注后多数可于短期内迅速恢复 ,但较长时间缺血后再灌注可发生

The Occurrence and Outcome of Arrhythmia Induced by Acute Occlusion and Reperfusion of Right Coronary Artery in Rabbits in Vivo

To study the occurrence and outcome of arrhythmia induced by acute occlu sion and reperfusion of right coronary artery,ninety healthy adult rabbits were divided randomly into control group,ischemia groups (I) 10 min(I 10 min ),30 min(I 30 min ),60 min(I 60 min ) and 120 min(I 120 min ) and ischemia and reperfusion(IR) groups (10 min,30 min,60 min and 120 min ischemia f ollowed by 4 h reperfusio n respectively)(I 10 min R 4 h ,I 30 min R 4 h ,I 60 min R 4 h and I 120 min R 4 h ).Both the control group and each su bgroup had 10 rabbits.IR injury model of sinoatrial node was established by occl uding and loosening the start section of right coronary artery.The changes of AA ,AH,HV interval and arrhythmia were recorded by electrocardiogram and cardiac ch amber electrograph synchronously.Results:①The AA,AH and HV interval of the cont rol group had no significant difference between each time points.②In experiment group,ventricular fibrillation was found in 3 rabbits,atrioventricular block(AV B) was found in 67 rabbi ts,sinus and atrial arrhythmia were found in 51 rabbits.54 out of 80 rabbits had a elongation of AA intervals (>40 ms).③15 out of 26 rabbits in IR group had si nus or atrial arrhythmia during ischemic period were recovered in 20 min after reperfusion.7 rabbits in IR group had AVB during ischemia recovered in 30 m in after reperfusion.The new arrhythmia occurred during reperfusion in 3 rabbits .④The elongation of AA,AH intervals during ischemic period recovered to pre oc clusion level after reperfusion,but the AA,AH intervals prolonged again in I 120 min R 4 h groups as the reperfusion elongated.Conclusion:The acute o cclusion of right coronary can decrease the frequency of sinoatrial node and ind uce AVB,and most of them can get right after reperfusion,but the reperfusio n after a long time ischemia can induce reperfusion arrhythmia.[ Chinese Journ al of Cardiac Pacing and Electrophysiology, 2003,17(1):48～51]