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目的研究低强度脊髓神经刺激(SCS)对心房电生理性质的影响。方法 12只成年家犬随机分为SCS组(n=6)和对照组(n=6),以戊巴比妥钠麻醉,在左上肺静脉、右上肺静脉、左下肺静脉、右下肺静脉、左房、右房位点缝置多电极导管,SCS组在T1~T5脊髓节段放置刺激电极并给予SCS 1 h,对照组放置刺激导线但不给予刺激。分别在基础水平和1 h后,心房基础起搏下,依次在心房和肺静脉各位点不应期内发放40 ms的高频刺激测定心房颤动(简称房颤)阈值(AF-TH),用S1S2程序刺激法测定心房有效不应期(ERP)和房颤易颤窗口(WOV)。结果SCS组1 h后与基础水平比较,心房和肺静脉各位点AF-TH增高,ERP延长,WOV减小(P均<0.05)。SCS组1 h后较对照组1 h后AF-TH增高,ERP延长,WOV减小(P均<0.05)。对照组基础水平与1 h后各指标无变化。结论SCS可显著改变心房电生理性质,抑制房颤可诱导性。
Objective To study the effect of low-intensity spinal cord stimulation (SCS) on the electrophysiological properties of atria. Methods Twelve adult dogs were randomly divided into SCS group (n = 6) and control group (n = 6), and anesthetized with sodium pentobarbital. The left upper pulmonary vein, right superior pulmonary vein, left lower pulmonary vein, right lower pulmonary vein, left atrium, In the right atrial site, a multi-lead catheter was placed. In the SCS group, the stimulation electrode was placed in the spinal cord segment of T1-T5 and SCS was administered for 1 h. The control group was placed with stimulation lead but without stimulation. Atrial fibrillation threshold (AF-TH) was measured by high-frequency stimulation for 40 ms at the basal level and 1 h after atrial pacing. Procedural stimulation method for determination of atrial effective refractory period (ERP) and atrial fibrillation (WOV) window. Results Compared with the basal level at 1 h after SCS, AF-TH increased, ERP prolonged and WOV decreased in all atria and pulmonary veins (all P <0.05). Compared with control group, AF-TH increased, ERP prolonged and WOV decreased in SCS group 1 h later (all P <0.05). The basic level of control group did not change after 1 h. Conclusion SCS can significantly change the electrophysiological properties of atria and inhibit the inducibility of atrial fibrillation.