经心内膜右房线形消融治疗心房颤动的安全性评价

Safety of Endocardial Application of Right Atrial Linear Ablation to Treat Experimental Atrial Fibrillation

为探讨经心内膜右房线形消融治疗心房颤动（简称房颤）的安全性，１２只犬以乙酰胆碱静脉滴注和（或）电刺激建立房颤模型，观察射频导管消融前、后实验犬的病理生理变化。结果显示：①与消融前相比，消融后窦性心率（１５０．８２±３６．７１ｂｐｍｖｓ１６３．６７±３０．９９ｂｐｍ）、窦性Ｐ波时限（７３．６４±１６．８０ｍｓｖｓ６９．５８±１２．１４ｍｓ）、ＰＲ间期（１２０．７３±２６．２９ｍｓｖｓ１１４．０２±１９．２１ｍｓ）、校正窦房结恢复时间（７６．２５±１８．８７ｍｓｖｓ７２．５０±１１．９０ｍｓ）、右房压力（０．４９±０．０６ｋＰａｖｓ０．４６±０．０８ｋＰａ）以及血浆心钠素（０．４８±０．１１ｎｇ／ｍｌｖｓ０．５０±０．０７ｎｇ／ｍｌ）变化均无显著性差异（Ｐ均＞０．０５）。血清磷酸肌酸激酶于消融后即刻明显升高（５２５．９５±４２６．４９Ｕ／Ｌｖｓ１１５．２７±２８．７０Ｕ／Ｌ，Ｐ＜０．０１），但术后１４日与消融前相比已无显著性差异（１１４．０２±２３．３５Ｕ／Ｌｖｓ１１５．２７±２８．７０Ｕ／Ｌ，Ｐ＞０．０５）。②４只犬发生并发症，其中１只损伤窦房结，２只发现心脏巨大附壁血栓，另１只术后出现一过性房性早搏、短阵房?

To investigate the safety of atrial fibrillation treatment with right atrial linear ablation,12 dogs with experimental atrial fibrillation underwent radiofrequency catheter ablation (RFCA).The results showed that there was no significant change in sinus rate (15082±3671 bpm vs 16367±3099 bpm),P wave duration (7364±1680 ms vs 6958±1214 ms),PR interval(12073±2629 ms vs 11402±1921 ms),corrected sinoatrial node recovery time (7625±1887 ms vs 7250±1190 ms),mean right atrial pressure (049±006 kPa vs 046±008 kPa) and plasma level of atrial natriuretic peptide (048±011 ng/ml vs 050±007 ng/ml),all P>0.05.Creatine kinase just after ablation was significantly highter than that of postablation (52595±42649 U/L vs 11527±2870 U/L,P<0.01),but it became normal 14 days after RFCA (11402±2335 U/L vs 11527±2870 U/L,P>0.05).No significant complication was found except for one sinus node dysfunction and two thromboembolic events.We conclude that right atrial linear ablation may be a safe technique.