直流电消蚀房室交界区的组织学观察

Histologic Observation of the Aerioventricular Junceion of Dogs after Direct-current Catheter Ablation

应用心内单极希氏束定位法，进行选择性电消蚀房室结及电消蚀希氏束的实验研究．取家犬２６只，随机分为两组，经实验后每只犬均在处死或自然死亡后取出心脏作病理检查，结果表明：心内电消蚀房室传导系统确能造成传导组织的明显改变，极少数甚至产生严重的组织损伤．因此，临床应用此技术时应严格掌握适应症，并积极进行方法学改进．

n experiment of selective ablation of A-V node and His bundle was conducted.Unipolar His bundle electrogram was used to determine the ablation site. 26 dogs wererandomly divided into two groups. Each dog was examined for histologic change of theheart and conduction system after it died or was killed. Results showed that heperemia,haemorrhagia,necrosis and degeneration of cardiac cells in discharging site were the mainearly damages.In later stage,the injury was circatricial tissue formed in damaging areas.The sphere of damaging sites has positive relation to the amounts of discharging energy.Theinjuring areas related to electrophysiologic changes were induced by ablating.But our resultsindicated that catheter ablation could produce a significant histologic change and even severeanatomic damages,so we recommend that the indications of catheter ablation be very im-portant in clinical uses.According to the electrophysiological results after ablation,wethink that the selctive A-V node ablation and modification of A-V conduction are idealmethods in treating supraventricular tachycardias.