左上肺静脉脂肪垫对犬心脏电生理特性的影响

目的观察射频消融左上肺静脉脂肪垫(left superior pulmonary vein fat pad,LSPV-FP)对心脏电生理特性的影响。方法 12只健康杂种犬,麻醉插管后持续心电监测;于双侧颈部暴露迷走神经干,左右侧第4肋间开胸暴露LSPV-FP;分别测量基础、刺激迷走神经、消融LSPV-FP、刺激迷走神经+消融LSPV-FP四种状态下的RR间期、窦房结恢复时间(SNRT)、房室结前传文氏点(WCL)、AH间期、HV间期及心房有效不应期(ERP)。结果①射频消融LSPV-FP对基础状态的心脏电生理特性无显著影响(P>0.05);②刺激左侧或右侧迷走神经干均可显著延长RR间期、SNRT、WCL、AH间期及缩短心房ERP(P<0.05),消融LSPV-FP可以明显削弱左侧迷走神经干刺激所导致的电生理变化(P<0.05),但对右侧迷走神经干刺激所导致的电生理变化无显著影响(P>0.05)。结论射频消融LSPV-FP对基础状态心脏窦房结、房室结电生理特性无显著影响,左侧迷走神经通过LSPV-FP发挥对心脏电生理的调节作用。

Effect of left superior pulmonary vein fat pad on cardiac electrophysiological characteristics in dogs

Objective To explore the functions of left inferior pulmonary vein fat pad(LSPV-FP) on the cardiac electrophysiological characteristics.Methods Twelve adult healthy mongrel dogs were anesthetized and ventilated,and their both cervical vagosympathetic trunks were exposed for stimulation.The LSPV-FP was exposed via thoracotomies at the 4th intercostal space of left and right chest.The RR interval,SNRT,WCL,AH interval,HV interval,ERP of atrium were measured in the following status,baseline,vagosympathetic trunks stimulation(VTS),LSPV-FP ablation.and VTS post LSPV-FP ablation.Results No significant electrophysiological change was observed before and after LSPV-FP ablation in the baseline(P>0.05).In the status of left vagosympathetic trunks stimulation(LVTS) or right vagosympathetic trunks stimulation(RVTS),the RR interval,SNRT,WCL,AH interval were lengthened,while the ERP of atrium were shortened.LSPV-FP ablation significantly attenuated all the changes induced by LVTS(P<0.05),but did not attenuate the changes induced by RVTS(P>0.05).Conclusion No significant difference in SN and AVN electrophysiology is observed before and after LSPV-FP ablation in baseline.Left vagosympathetic trunk plays a role in cardiac electrophysiology via LSPV-FP.