快速心房电刺激对人心房不应期的影响及卡托普利的干预作用

Effect of Rapid Atrial Electric Stimulating on the Atrial Effective Refractory Period and Intervention by Catopril.

探讨快速心房电刺激对人心房有效不应期 (AERP)的影响及卡托普利的干预作用。选择本院行射频消融术的 38例成年患者为研究对象 ,随机分为卡托普利组 (14例 )、维拉帕米组 (12例 )及生理盐水对照组 (12例 )。分别在阻断心脏自主神经后 ,观察各组用药前、后及快速心房刺激后AERP的变化及AF诱发情况。结果 :①快速心房刺激可使 5 7.9%成人正常心脏诱发AF ;②诱发AF后AERP明显缩短 ,而未诱发AF者的AERP无明显变化 ;③卡托普利及维拉帕米均能显著延长诱发AF患者的AERP ;④卡托普利能减少AF诱发率 ,并缩短AF持续时间 ;而维拉帕米则使AF诱发率增加、持续时间延长。结论 :①快速心房刺激可使部分患者AERP缩短 ,并诱发这类患者发生AF ;②卡托普利可显著延长诱发AF患者的AERP ,并使AF诱发率降低。

Department of Cardiology,Southwest Hospital,Third Military Medical University,Chongqing 400038,ChinaThe purpose of the study is to investigate the effect of rapid atrial electric stimulating on the atrial effective refractory period(AERP) and the intervention effect of Catopril.38 adult patients with tachyarrhythmia undergoing radiofrequency catheter ablation in our hospital were randomly divided into Catopril group(14 patients),Verapamil group(12 patients) and saline control group(12 patients).After blocking autonomic nerve,the effect of rapid atrial stimulation and drugs on AERP and atrial fibrillation(AF) were recorded.Results:①57.9% of the normal adults can be induced AF by rapid atrial stimulation.②After AF was induced,AERP of the patients with AF significantly shortened,but AERP of the patients without AF had no obvious change.③Catopril and Verapamil could significantly lengthen AERP of the patients with AF.④Catopril could significantly shorten the time and duration of AF,but Verapamil obviously increased the times and duration of AF.Conclusion:①rapid atrial stimulation could shorten the AERP of the part of the normal adults and could induce the AF attack of this parts.②Catopril could prolong the AERP and prevent AF attack.