迷走神经张力与碎裂电位及房颤之间的关系研究

目的研究迷走神经张力与碎裂电位及房颤之间的关系研究。方法健康成年杂种犬15只随机分为3组,A组心外膜脂肪垫注射氯化乙酰胆碱（Ach）1mg;B组心外膜脂肪垫注射氯化乙酰胆碱5mg;C组心外膜脂肪垫注射生理盐水共5ml。3组均于注射后行BURST刺激记录房颤诱发与否,房颤诱发时间,左房侧壁（A点）、左房后壁（B点）、左心耳（C点）碎裂电位持续时间。结果 C组房颤诱发率于注射生理盐水前后予BURST刺激无明显变化。A、B组乙酰胆碱注射后房颤诱发率显著增加,但A、B两组房颤诱发率无显著变化。C组房颤持续时间较A组[C vs A：（7.00±2.10）svs（50.42±6.36）s,P=0.013;C vs B：（7.00±2.10）s vs（143.24±11.28）s,P〈0.001]短。B组房颤持续时间长于A组[（143.24±11.28）s vs（50.42±6.36）s,P〈0.001]。C组左房侧壁,后壁位点碎裂电位持续时间均较A、B组相应位点短。[C,A,B组：A点（2.2±0.5）s vs（37.4±6.3）s vs（132.5±12.7）s,P〈0.0001];[B点（2.2±0.5）s vs（37.2±6.3）svs（132.5±12.7）s,P〈0.001];C组左心耳（C点未能记录到碎裂电位）。A组碎裂电位持续时间较B组短[A点：（37.4±6.3）s vs（132.5±12.7）s,P〈0.001;B点：（37.2±6.3）s vs（132.5±12.7）s,P〈0.0001;C点：（35.1±6.7）s vs（130.7±13.3）s,P〈0.0001]。A,B组自身对照,左心耳位点较左房侧壁、后壁碎裂电位持续时间短[A组：（37.4±6.2）svs（37.2±6.3）s vs（35.1±6.7）s,P〈0.0001;B组：（132.4±12.7）s vs（132.5±12.7）s vs（130.7±13.3）s,P〈0.0001]。C组左房侧壁,后壁碎裂电位时间差异无统计学意义（2.25±0.5）s vs（2.25±0.5）s,P=0.183]。结论迷走神经张力越高,越容易产生碎裂电位,则房颤持续时间愈长。

The relationship between vagal tone and complex fractionated atrial electrogram and atrial fibrillation

Objective To investgate into the relationship between vagal tone and complex fractionated atrial electrogram（CFAE） and atrial fibrillation（AF）.Methods15 healthy mongrel dogs were randomly divided into three groups—A,B and C group.1mg and 5mg acetylcholine chloride（Ach） was injected into each dog in group A and B respectively,and 5ml normal saline was injected into each dog in group C.The incidence and duration of AF in the dogs of the three groups which underwent BURST stimulation after the drug injection were recorded.CFAE duration of left atrial lateral wall（point A）,left atrial posterior wall（point B） and left atrial appendage（point C） were also recorded.ResultsThere was no significant difference between before and after the injection of normal saline in terms of induced rate of AF in the group C.After the injection of acetylcholine,the induced rate of AF was increased significantly in group A and B respectively,but there was no significant difference between group A and B.The duration of AF in group C was shorter than that in group A and B[C vs.A：（7.00±2.10）s vs（50.42±6.36）s,P=0.013;C vs.B：（7.00±2.10）s vs（143.24±11.28）s,P〈0.001].The duration of AF in group B was longer than that in group A [（143.24±11.28）s vs（50.42±6.36）s,P〈0.001].The CFAE duration of the sites in the left atrial lateral wall and posterior wall in group C was shorter than those in group A and B [group C,A and B：point A（2.2±0.5）s vs（37.4±6.3）s vs（132.5±12.7）s,P〈0.0001;point B（2.2±0.5）s vs（37.2±6.3）s vs（132.5±12.7）s,P〈0.001].CFAE could not be recorded in the point C in the left atrial appendage in group C.The CFAE duration in the group A was shorter than that in the group B[point A：（37.4±6.3）s vs（132.5±12.7）s,P〈0.0001;point B：（37.2±6.3）s vs（132.5±12.7）s,P〈0.0001;point C：（35.1±6.7）s vs（130.7±13.3）s,P〈0.0001）.The CFAE duration of the left atrial appendage site was shorter than that of the left atrial lateral and posterior wall sites both in group A and B [group A：（37.4±6.2）s vs（37.2±6.3）s vs（35.1±6.7）s,P〈0.0001;group B：（132.4±12.7）s vs（132.5±12.7）s vs（130.7±13.3）s,P〈0.0001].There was no significant difference between the left atrial lateral wall and posterior wall in terms of CFAE duration[（2.25±0.5）s vs（2.25±0.5）s,P=0.183].ConclusionThe higher the vagal tone was,the more likely the CFAE appeared and the longer the duration of AF was.