通过单相动作电位评价不同部位起搏时猪整体心脏复极离散变化

Global dispersion of ventricular repolarization with pacing at difference sites： in vivo evaluation by monophasic action potential mapping in swine

目的 通过对猪心脏不同部位起搏,观察不同激动顺序对整体心脏复极离散的影响.方法 10只健康猪,应用电解剖标测系统（Carto系统）,在右心房（RA）、右心室心尖部心内膜（RVEndo）及左心室后壁心外膜（ LVEpi）起搏,分别标测左心室（LV）及右心室（RV）心内膜单相动作电位（MAP）,测量不同部位起搏时的整体心室激动时间（AT）离散及整体心室复极结束时间（EOR）离散.结果 平均每个心室标测（ 121 ±35）个点,RA起搏时EOR为（63±12） ms,LVEpi起搏时EOR为（94±17） ms,RVEndo起搏时EOR为（72±18） ms; LVEpi起搏时EOR明显长于RA起搏时EOR（ P＜0.05）,RVEndo起搏与RA起搏EOR差异无统计学意义（P＞0.05）.结论 LVEpi起搏时整体心室肌复极离散较RA及RVEndo起搏时明显增加.

Objective To study the global dispersion of ventricular repolarization under different sites pacing in pigs.Methods Using the Carto system,monophasic action potential（MAP） mapping of the left and right ventricular endocardium was performed during right atrial（RA） pacing,right ventricular apical endocardial （RVEndo ） pacing and left ventricular lateral epicardial（ LVEpi ） pacing in 10 healthy pigs.Global dispersion of the activation time（AT） and end of repolarization time（EOR） were calculated as the maximal differences of these 2 parameters in each map.Results The global dispersion of EOR times during LYEpi pacing（94±17） ms was significantly greater than those during RA[ （63±12）ms,P〈0.05] and RVEndo pacing[ （72±18）ms,P〈0.05）],whereas no significant difference was found between those during RA and RVEndo pacing（P〉0.05）.Conclusion Compared to RA and RVEndo pacing,LVEpi pacing increases the global dispersion of ventricular repolarization.