实验性犬心房颤动及右房心外膜射频消融的研究

An experimental study of canine atrial fibrillation and right atrial epicardial radiofrequency ablation therapy

目的建立心房颤动(房颤)动物模型并探索右房心外膜射频消融治疗房颤的可行性。方法在8条犬建立无菌性心包炎房颤模型,然后进行右房心外膜的多线射频消融治疗。结果在犬无菌性心包炎模型可诱发持续性的房颤,术后第一天诱发率最高,但术后1～4日所诱发房颤的持续时间差异无显著性(P>0.05)。右房心外膜射频消融结束后,房颤诱发率明显降低(100%vs 25%,P<0.01),房颤时间缩短(22.18±10.29 min vs 9.78±3.24 min P<0.01)。消融前后窦房结恢复时间与房室结有效不应期无明显变化(P>0.05)。消融结束后,病理检查发现消融部位心房肌损伤为连续性、透壁性的凝固性坏死。结论犬无菌性心包炎模型是一种容易建立的可靠的房颤模型,单纯右房心外膜线性射频消融治疗可明显减少房颤的诱发率和房颤持续时间,这点可能对人类房颤的治疗有启示。

Objective To establish an animal model of atrial fibrillation(AF)and assess the feasi- bility of right atrial epicardial radiofrequency ablation therapy of AF.Methods The models of AF were es- tablished in 8 dogs by producing sterile pericarditis through operation.The epicardial linear ablation on right atrium was performed on the 4th day after operation.Results The highest inducible rate of AF was on the 1st day after operation,but there was no significant difference in the duration of induced AF on 1st to 4th day after operation.After ablation,the inducible rate of AF was significantly decreased(100% vs 25%,P<0.01)and the duration was much shorter than pre-ablation(22.18±10.29 rain VS 9.78±3.24 min)even if AF was induced.No statistical significance was found in SNRT and ERP_(AVN)measured before and after ablative procedure.Pathological examination after ablation showed that atrial ablation lesions were continuous and transmural coagulative necrosis.Conclusion Canine sterile pericarditis models for inducing AF is reliable and right atrial linear radiofrequency ablation reduces the inducible rate and the duration of AF significantly,which may have some implication on the exploration of human AF therapy.