心脏神经节丛在诱发房颤中的作用

目的:心脏自主神经系统包括内在神经系统和外在神经系统。心房颤动(房颤)是最常见的持续性心律失常之一,心脏内在神经系统是否能独立诱发房颤尚不十分清楚。本实验旨在观察心脏内在神经系统在房颤诱发中的独立作用。方法:采用10只实验用犬,建立Langenfroff离体灌流心脏模型,在基础状态下,刺激心脏神经节丛时,分别测量心房有效不应期、肺静脉有效不应期以及房颤诱发率。结果:刺激心脏神经节丛能够缩短心房有效不应期(基线:(129±11)ms;刺激:(105±17)ms;P<0.05),以及缩短肺静脉有效不应期(基线:(136±12)ms;刺激:(112±14)ms;P<0.05)。同时能显著增加房颤的诱发率(基线:7%;刺激:93%;P<0.05)。结论:在完全去除心脏外在神经支配的情况下,心脏内在神经系统张力增高,能够独立诱发房颤。心脏内在神经系统组成的局部环路在房颤的产生中起重要作用。

The independent effect of the epicardial ganglionated plexi in the initiation of atrial fibrillation

Objective: The cardiac nervous system includes the internal cardiac nervous system and the external cardiac nervous system.Atrial fibrillation(AF) is a kind of the most common persistent arrhythmias.Whether the internal cardiac nervous system is able to induce AF independently is still unknown.The study aimed to observe the independent functions of the internal cardiac nervous system in the initiation of AF.Methods: In Langenfroff perfusion cardiac models in vitro from 10 dogs,we measured atrial effective refractory period,pulmonary vein effective refractory period and atrial fibrillation induced rate with the stimulation of the heart ganglion plexus at the basic state.Results: The stimulation of the heart ganglion plexus could shorten the atrial effective refractory period(baseline: 129±11 ms;stimulating: 105±17 ms;P<0.05),and shorten the pulmonary vein effective refractory period(baseline: 136±12 ms;stimulating: 112±14 ms;P<0.05),while,significantly increase the atrial fibrillation induced rate(baseline: 7%;stimulus: 93%;P<0.05).Conclusion: In completely removing the control of the heart external nervous system,tension of the internal cardiac nervous system increased,then independently induced AF.The internal cardiac nervous system formed the local loop and played an important role in the initiation of AF.