心室局部应用乌头碱诱发室性心律失常的实验研究

Experimental ventricular tachyarrhythmias induced by aconitine on the local ventricular epicardium

为开展消除局部致心律失常病灶心肌组织的实验研究,本工作建立了适宜的动物模型。在12只犬心室局部心外膜上进行了36次给予乌头碱滤纸片诱发室性心律失常的实验。在给予乌头碱(6.1±4.5μg,n=36)后均诱发出严重的持续性单一形态室速。53%(19/36)的室速在持续256±234秒之后转变为室颤。室速时血液动力学状况明显恶化。局部心外膜等时标测图显示在心外膜上20×20mm^2的标测区域内存在一个以上的提前激动50～90ms的突破点,在心外膜等时标测指导下用Nd:YAG激光消除了全部病灶心肌,使心脏转复为窦性心律。

It is necessary to establish an animal model for the purpose of experimental study of ablative procedures directed at the arrhythmogenic substrate. Ventricular tachyarrhythmias were induced by pieces of filter paper containing little aconitine on the local ventricular epicardium on 12 canine hearts for 36 tests. Monographic persistent ventricular tachycardia (VT) were brought out in each test after applying aconitine (6.1±4.5μg, n=36) on the epicardium. 53% (19/36) of VT turned to ventricular fibrillation (VF) after they had persisted for 256±234 seconds. Hemodynamtc condition decreased greatly during VT. Local epicardial isochronal map showed that: there were more than one breakthrough which preexcited for 50～90ms in the 20×20mm^2 mapping area of the epicardium. Heart rhythm was controlled by one of the ectopic foci. Under the guidance of local epicardial isochronal map, all of VT or VF foci were ablated by Nd: YAG laser photocoagulation and sinus rhythm were resumed.