微创技术下兔急性心房颤动模型的建立

The Establishment of Rabbit Model of Acute Atrial Fibrillation with Tiny Trauma Technology

目的探索在药物诱导下经食管高频刺激左心房建立兔急性心房颤动动物模型的效果及机制。方法 45只新西兰大耳白兔随机分为实验组(n=15)、对照组一(n=15)、对照组二(n=15)。对照组一经耳缘静脉持续泵入混合药物(2g/L氯乙酰胆碱56ml、去乙酰毛花苷2ml、异丙肾上腺素2ml),经食管置入电极(冠状窦10极电极)但不予Burst刺激。对照组二单纯经食管电极给予左心房Burst刺激。实验组通过耳缘静脉持续泵入混合药物,并经食管电极Burst刺激左心房建立兔急性房颤模型。根据心室率变化调整药物剂量,当心室率控制为基础心室率1/3时,经食管电极行S1S11000次/min的Burst刺激,观察房颤情况,将>30min的房颤视为诱发成功。统计食管电极深度及诱发房颤时药物浓度,监测房颤发生情况、持续时间、房颤前后心室率及心房有效不应期(AERP)变化。结果实验组15只兔中11只成功诱发出持续时间>30min的房颤,诱发率73%;两对照组均未诱发出房颤。房颤持续时间(44±10)min,分别与两对照组比较均有显著统计学意义(P<0.01)。房颤时心室率(133±7)次/min明显快于Burst刺激诱发前(经静脉应用混合药物将心室率控制于基础心室率1/3,未行Burst刺激前)心室率(109±5)次/min,有显著统计学意义(P<0.01)。房颤后AERP(75±8)ms明显短于基础(未应用药物时测定)AERP(116±8)ms,有显著统计学意义(P<0.01)。诱发房颤混合药物剂量(18.6±1.7)ml/h,食管电极深度(16.8±0.5)cm。结论经静脉持续泵入混合药物(2g/L乙酰胆碱56ml、去乙酰毛花苷2ml、异丙肾上腺素2ml),并结合食管电极给予左心房Burst刺激方法构建兔急性房颤模型成本低、诱发率高、重复性好、创伤小、建模周期短、操作简单,运用微创技术建立了一种新的房颤模型的制作方法。

Objective To establish rabbit model of acute atrial fibrillation by TEAP（transesophagus atrial pacing） with high frequency combined with drugs and explore its effect and mechanism.Methods 45 rabbits were randomly divided into 3 groups.（1）The first control group（n=15）,intravenous infusion of compound drugs which include acetylcholine,deacetylase ianatoside and isoproterenol.Implant coronary sinus electrode to the level of left atrial through esophagus without Burst（S1S1=1000bpm） stimulation.（2）The second control group,TEAP（transesophagus atrial pacing） with Burst（S1S1=1000bpm） stimulation without compound drugs infused.（3）The experimental group,TEAP after compound drugs infused.If the sustaining duration of atrial fibrillation exceed 30 minutes,we regard it as successful.The length of the electrode,the dose of mixed drugs,the incidence of atrial fibrillation,the sustaining duration of atrial fbrillation,the ventricular rate before and after atrial fibrillation,the atrial effective refractory period before and after atrial fibrillation were statistic analyzed.Results There were 11 rabbit models of acute atrial fibrillation in experimental group and was not any successful model in another two control groups（incidence rate 73% vs 0%,P0.01）.The ventricular rate（133±7）bpm when atrial fibrillation developing was faster than（109±7）bpm before Burst stimulation（P0.01）.AERP was shorter after atrial fibrillation developing than the preceding AERP（P0.01）.The compound drugs dose was（（18.6±1.7）ml/h）.The depth of electrode was（16.5±0.5）cm.Conclusion Intravenous infusion of compound drugs combined with TEAP with Burst stimulation can effectively establish rabbit model of acute atrial fibrillation.It is a new inexpensive,reproducible,minimally invasive,rapid and simple method.