植入型心电监测仪在慢性阻塞性睡眠呼吸暂停犬心律失常模型中的应用

Application of insertable cardiac monitor in arrhythmia model of dogs with chronic obstructive sleep apnea

目的探索利用植入型心电监测仪(ICM)在慢性阻塞性睡眠呼吸暂停(OSA)犬心律失常模型中的应用。方法10只比格犬在长期反复气道通气限制下建立慢性OSA模型,并在造模开始前全身麻醉下植入ICM。初次程控设置心动过速事件为>182次/min,心动过缓事件<60次/min,每周程控,连续记录3个月。结果10只犬均成功植入ICM,未发生切口及囊袋感染等植入后不良事件,术后程控R波高度均>0.3 mV,12周造模期间稳定记录到犬心房自发高频事件,1~12周自发房性心动过速(房速)发生率为17.00%±13.34%,自发心房颤动(房颤)发生率为12.50%±11.38%,窦性心动过缓发生率为23.05%±16.70%,并且窦性心动过缓发生率显著高于自发房速和自发房颤(P=0.001)。监测窦性心动过缓事件显著高于自发房速和自发房颤[(8.25±4.94)次对(4.00±2.63)次对(2.00±1.81)次,P<0.001]。结论在犬慢性OSA模型中ICM可作为长程检测心律失常设备,记录数据稳定、可靠。

Objective To explore the application of implantable electrocardiogram(ECG)monitoring device[insertable cardiac monitor(ICM)]in ananimal model of arrhythmia with chronic obstructive sleep apnea.Methods The chronic obstructive sleep apnea model was established in 10 Beagle dogs under the restriction of long-term recurrent airway ventilation,and ICM was implanted under general anesthesia before the establishment of the model.The first programmed event of tachycardia was more than 182 bmp,and the bradycardia event was less than 60 bpm.The tachycardia event was programmed weekly and recorded continuously for 3 months.Results All 10 dogs were successfully implanted with ICM,and no post-implant adverse events such as incisions and capsular bag infections occurred.Post-programmed R-wave heights were all greater than 0.3 mV.Spontaneous high-frequency events in the atrium of dogs were stably recorded during 12 weeks of modeling.The incidence of spontaneous atrial tachycardia was 17.00%±13.34%,the incidenceof spontaneous atrial fibrillation was 12.50%±11.38%;the incidence of sinus bradycardia was 23.05%±16.70%.The incidence of bradycardia was significantly higher than spontaneous atrial tachycardia and spontaneous atrial fibrillation(P=0.001).Moreover,sinus bradycardia events were significantly higher than spontaneous atrial tachycardia and spontaneous atrial fibrillation[(8.25±4.94)times vs.(4.00±2.63)times vs.(2.00±1.81)times,P<0.001)].Conclusion Abandoned ICM could be used as a long-term arrhythmia detection equipment in the model of chronic obstructive sleep apnea in canine.