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目的:建立右心房梗死伴左心房高频起搏新型慢性心房颤动(AF)模型并探讨其电生理特性。方法:24只健康新西兰大白兔随机分为3组:对照组(C)、起搏组(P)、心房梗死+起搏组(I)。C组:在左心房外膜缝合固定一起搏电极,但不起搏;P组:在左心房外膜缝合固定一起搏电极并以1000beats/min的频率高频起搏;I组:结扎右冠状动脉心房分支,并在左心房外膜缝合固定一起搏电极,以1000beats/min的频率高频起搏。采用心外膜程序起搏技术测定心房肌的电生理特性。结果:(1)I组:起搏3周后AF诱发成功率高达100%。(2)I组、P组在起搏1h、1周、3周后心房有效不应期(ERPA)均缩短;I组、P组、C组:起搏3周后在基本起搏周期(PCL)200ms时的ERPA分别为(87.5±12.8)ms、(81.3±12.5)ms、(115.0±7.6)ms,I组、P组与C组比较,显著差异(P<0.01)。(3)在频率适应性方面,I组、P组均表现为频率适应不良,在术后3周时表现明显,与C组比较差异显著(分别P<0.01,P<0.05)。(4)I组在起搏3周后P波时限延长与P组、C组比较差异显著(P<0.05,P<0.01)。(5)I组:快速起搏后1h至3周,均表现为ERPA缩短、心房相对不应期(RRPA)延长与C组比较显著差异(P<0.01)、房间传导时间(IACD)延长与P组、C组比较显著差异(均P<0.01)。结论:右心房梗死+左心房高频起搏建立兔慢性AF与传统的单纯心房起搏相比,AF诱发成功率高并且稳定,其电生理参数有特征性意义,表现为ERPA缩短,频率适应不良,RRPA延长,IACD延长。
Objective: To establish a new type of chronic atrial fibrillation (AF) model of right atrial infarction with left atrial pacing and investigate its electrophysiological characteristics. Methods: Twenty-four healthy New Zealand white rabbits were randomly divided into three groups: control group (C), pacing group (P), atrial infarction + pacing group (I). Group C: sutured and paced electrodes in the left atrial adventitia, but no pacing; Group P: sutured and paced electrodes in the left atrial adventitia and pacing at a frequency of 1000beats / min; Group I: ligation of the right coronary Arterial atrium branches and sutured atrial electrodes in the left atrial appendage to high-frequency pacing at 1000 beats / min. Electrocardiographic Characteristics of Atrial Muscle Using Cardiac Epicardial Pacing Technique. Results: (1) Group I: The successful induction rate of AF was as high as 100% after 3 weeks of pacing. (2) Group I and group P shortened the atrial effective refractory period (ERPA) after pacing for 1h, 1 week and 3 weeks; Group I, group P and group C: After 3 weeks of pacing, (87.5 ± 12.8) ms, (81.3 ± 12.5) ms, and (115.0 ± 7.6) ms respectively at 200ms in PCL group. There was significant difference between I group, P group and C group (P <0.01). (3) In terms of frequency adaptability, group I and group P showed frequency maladjustment and showed obvious at 3 weeks after operation, which was significantly different from that in group C (P <0.01, P <0.05, respectively). (4) Compared with P group and C group, the prolongation of P wave time in group I after 3 weeks of pacing had significant difference (P <0.05, P <0.01). (5) In group I, the shortening of ERPA and the prolongation of atrial relative refractory period (RRPA) were significantly different from those in C group (P <0.01), prolongation of conduction time of room (IACD) and P group, C group were significantly different (all P <0.01). Conclusion: Compared with the traditional simple atrial pacing, chronic AF induced by right atrial infarction and left atrial high-frequency pacing has a high success rate and stable induction of AF, and its electrophysiological parameters have characteristic significance, which is shortening of ERPA, frequency adaptation Poor, RRPA extended, IACD extended.