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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。
Objective To observe the effects of radiofrequency ablation of left superior pulmonary vein fat pad (LSPV-FP) on cardiac electrophysiology. Methods 12 healthy mongrel dogs were anesthetized and intubated for continuous electrocardiogram (ECG) monitoring. LSPV-FP was exposed in bilateral cervical intervertebral exposed vagus nerve trunk and thoracotomy on the left and right intercostal space. LSPV-FP was measured and stimulated vagus nerve, RR interval, SNRT, WCL, AH interval, HV interval and atrial effective refractory period in four states of vagal nerve + ablation LSPV-FP ERP). Results ① Radiofrequency ablation of LSPV-FP had no significant effect on cardiophysiological characteristics of basal state (P> 0.05); ② stimulation of left or right vagus nerve trunk significantly prolonged RR interval, SNRT, WCL, AH interval and shortening Atrial ERP (P <0.05), ablation of LSPV-FP significantly attenuated the electrophysiological changes induced by left vagus nerve stimulation (P <0.05), but had no significant effect on electrophysiological changes induced by vagal stimulation > 0.05). Conclusions Radiofrequency ablation of LSPV-FP has no significant effect on basal cardiac atrial node and atrioventricular node electrophysiological characteristics. The left vagal nerve exerts a regulatory effect on cardiac electrophysiology through LSPV-FP.