犬双上肺静脉起搏建立心房颤动模型的研究

doi:10.3969/j.issn.1674-5817.2013.03.006

摘要/Abstract

摘要： 目的探讨经快速双上肺静脉起搏方法制作犬心房颤动动物模型的可行性。方法 10只健康比格犬经开胸途径植入十极导管电极,快速(1 200次/min)起搏双上肺静脉6 h。观察房颤诱发情况,对起搏前后双上肺静脉及左心耳电生理检查结果进行比较。结果 8只犬完成实验,房颤诱导成功率80%。高频率刺激诱发的房颤模型能使双上肺静脉区及左心耳部位ERP先降低后升高(145±15.1 vs 130±16.3 vs 136±11.4, P=0.004、P=0.494),存在统计学显著差异。诱发房颤5 h后,总的房颤诱发窗口(∑WOV) 较基线略有升高,但无明显统计学差异(26.7±65.3 vs 20±52.9,P>0.05)。而在乙酰胆碱诱发房颤(第0 h、1 h、3 h、6 h)时,可见房颤的诱发时间呈现先上升后下降的过程,而这种趋势与ERP的变化趋势存在相关性。结论经快速双上肺起搏方法制作心房颤动动物模型,可用于房颤发病机理、电生理重构、心肌重构、分子生物学改变等临床研究,也可用于心动过速性心肌病及部分心力衰竭的研究。

关键词: 双上肺静脉起搏, 心房颤动, 动物模型, 犬

Abstract: Objective To evaluate the feasibility of double-superior-pulmonary veins (PVs) pacing in building atrial fibrillation(AF) model in canine. Methods After open-chest surgery, two decapolar catheter were implanted outside left- and right- superior PVs in 10 healthy Beagle dogs, rapid pacing (1 200 beat/min) were simultaneously performed for 6 hours. AF inducibility, effective refractory period (ERP) and window of vulnerability (WOV) were measured. Results AF model was successfully built in 8 canines. AF induction rate was 80%. After rapid pacing, a significant decrease and then increase could be found in ERP recording (145.±15.1 vs 130±16.3^* vs 136±11.4^**, ^*P=0.004. ^**P=0.494). After five hours AF inducing, the total atrial fibrillation induce window (? WOV) were increased, as compared with the baseline, but without significant difference (26.7±65.3 vs 20±52.9, P>0.05). While in AF model induced by acetylcholine (0,1,3,6 hours), the time of atrial fibrillation induced were first rising then declining, and this trend and the correlation between the change trend of ERP. Conclusion Double superior PV pacing model can be used in pathogenesis of atrial fibrillation, electrophysiology reconstruction, myocardial reconstruction, molecular biology change clinical research, also can be used for tachycardia sex and part of heart failure cardiomyopathy.

Key words: Pacing, Double surperior pulmonary veins, Atrial fibrillation (af), Animal model, Dog

中图分类号:

Q95-33

陈世权, 盛夏, 黄松群, 宫鑫成, 蒋晨阳. 犬双上肺静脉起搏建立心房颤动模型的研究[J]. 实验动物与比较医学, 2013, 33(3): 195-199.

CHEN Shi-quan, JIANG Chen-yang, SHENG Xia, HUANG Song-qun, GONG Xin-cheng. Atrial Fibrillation Model By Pacing Double Surperior Pulmonary Veins[J]. Laboratory Animal and Comparative Medicine, 2013, 33(3): 195-199.

参考文献

[1] Braunwald E.Cardiovascular medicine at the turn of the millennium: triumphs, concerns, and opportunities[J]. N Engl J Med, 1998, 337(19):1360-1369.
[2] Fuster V, Rydén LE, Cannom DS,et al.American College of Cardiology/American Heart Association Task Force on Practice Guidelines; European Society of Cardiology Committee for Practice Guidelines; European Heart Rhythm Association; Heart Rhythm Society. ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society[N]. Circulation,2006 ,114(7):e257-354.
[3] Scherlag BJ, Yamanashi W, Lazzara R et al. Autonomically induced conversion of pulmonary vein focal firing into atrial fibrillation[J]. J Am Coll Cardiol, 2005, 45(11):1878-1886.
[4] Haďssaguerre M, Jaďs P, Shah DC, et al.Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins[J]. N Engl J Med, 1998, 339(10):659-666.
[5] Freudenberger RS, Hellkamp AS, et al.SCD-HeFT Investigators. Risk of thromboembolism in heart failure: an analysis from the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT)[J]. Circulation, 2007, 115(20):2637-2641.
[6] Avitall B, Urbona A, Urboniene D, et al.Linear lesions provide protoetion from atrial fibrillation induction with rapid atrial pacing[J]. J Cardiovas Electrophysiol, 2002, 13(5):455-462.
[7] Moe GK.The multiple wavelet hypothesis of atrial fibrillation[J]. Arch Int Pharmacodyn Ther, 1962, 0(140):183-188.
[8] 杨曙光, 王思让, 王玉堂, 等. 犬无菌性心包炎心房颤动模型的建立[J]. 中国心脏起搏与心电生理杂志, 1998, 12(3):149.
[9] 梁兆光, 姜玉萍, 刘和平, 等. 低通气量犬心房颤动模型的建立[J]. 中国心脏起搏与心电生理杂志,1998, 0(12):132-133.
[10] 侯月梅, 阿依古力, Benjamin J.Scherlag等. 心脏血管内迷走神经丛刺激与阵发性心房颤动的动物模型制作[J]. 中国心脏起搏与心电生理杂志, 2003, 17(3):200-202.
[11] 杨诏旭, 蔡振杰, 下跃民, 等. 乙酰胆碱诱发火急性心房颤动模型的研究[J], 心脏杂志, 2002, 14(3):195-198.
[12] 周更须, 马涛, 蔡振杰, 等. 建立犬心房颤动模型的研究[J].中国心脏起搏与心电生理杂志, 1997, 11(3):134-136.
[13] 郭成军, 胡大一, 杨新春, 等. 用实验性心力衰竭制作持续性心房颤动模型[J]. 中国心脏起搏与心电生理杂志,1998, 12(2):91-94.
[14] Marrouche NF, Martin DO, Wazni O, et al.Phased-array intracardiac echocardiography monitoring during pulmonary vein isolation inpatients with atrial fibrillation: impact on outcome and complications[J]. Circulation, 2003, 107(21): 2710-2716.
[15] 刁鸿英, 马长生, 刘兴鹏, 等.犬慢性快速心房起搏心房颤动模型的建立[J]. 中国心脏起搏与心电生理杂志, 2001,15(2):98-100.
[16] 张凤祥, 陈明龙, 杨兵, 等. 心外膜左心耳起搏建立山羊心房颤动模型[J]. 中国心脏起搏与心电生理杂志, 2008, 22(1):65-67.
[17] Lu ZB, Scherlag BJ, Niu G, et al.Atrial fibrillation begets atrial fibrillation: Autonomic mechanism for atrial electrical remodeling induced by short-term rapid atrial pacing[J]. Circulation, 2008, 1(3):184-192.
[18] Xia Sheng, Scherlag BJ, Yu L, et al.Prevention and reversal of atrial fibrillation inducibility and autonomic remodeling by low-level vagosympathetic nerve stimulation[J]. Am Coll Cardiol, 2011, 57(5):563-571.
[19] Wyse DG, Waldo AL, Halperin JL, et al.A comparison of rate control and rhythm control in patients with atrial fibrillation[J]. N Engl J Med, 2002;347(23):1825-1833.
[20] Corley SD, Epstein AE, DiMarco JP, et al. Relationships between sinus rhythm, treatment,survival in the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) Study[J]. Circulation, 2004, 30,109(12):1509-1513.