再灌注性心律失常的电生理实验研究

ELECTROPHYSIOLOGIC STUDY OF REPERFUSION ARRHYTHMIAS

本文在20只犬实验性缺血—再灌注时。应用心电活动三维标测系统。对心肌多层次(双极针电极)进行电生理检查。结果表明,27%的非持续性室性心动过速(下简称室速)起源于缺血区的心内膜下,并与室速前—窦性心搏在缺血区发生延迟激动有关,支持壁内折返机制;73%的非持续性室速起源于再灌注的正常交界处的心内膜下,支持非折返机制,导致心室颤动(下简称室颤)的室速也起源于再灌注的正常交界处的心内膜下,支持非折返机制。上述结果支持再灌注性心律失常的多种机制学说。

Twenty dogs of experimental ischemic reperfusion were studied with a three-dimensional mapping system of cardiac electric activity and multiple-level myocardial recordings by bipolar plunge-needle electrodes. 27% of the nonsustained ventricular tachycardia (NSVT) of intramural reentry occurred in the ischemic subendocardium by the side of delayed myocardial activation in the ischemic zone from the preceding sinus beat. 3% of the NSVT occurred in the subendocardium of the normal zone adjacent to the reperfused zone via a mechanism not involving reentry, so did VT leading to ventricular fibrillation. The results support that multiple mechanisms are involved in reperfusion arrhythmias.