无水乙醇经心外膜消融犬Marshall韧带方法学研究

Research on the methods of epicardial ablation of ligament of Marshall by alcohol in canine

目的 :评价直视下经心外膜无水乙醇化学消融Marshall韧带对犬Marshall韧带电位的影响。方法 :对19只犬直视下经心外膜应用自制梳状电极对Marshall韧带进行标测 ,其中连续对可记录到Marshall韧带电位的 11只犬 ,在Marshall韧带冠状静脉窦入口处及其中段与左心房连接处采用无水乙醇注射化学消融方法 ,消融Marshall韧带使其Marshall韧带电位消失。结果 :11只犬经心外膜无水乙醇化学消融方法消融Mar shall韧带 ,Marshall韧带电位消失率 10 0 % ,其中 9只犬Marshall韧带心外膜双极电图呈“V”字形 ,在Marshall韧带冠状静脉窦入口处消融后Marshall韧带电位全部消失 ;2只Marshall韧带心外膜双极电图呈“Y”字形 ,不仅在Marshall韧带冠状静脉窦入口处消融 ,而且在Marshall韧带中段电位提前处消融 ,经上述两处消融后 ,Marshall韧带电位全部消失。结论 :无水乙醇化学消融Marshall韧带方法简单 ,消融成功率高 ,安全可靠。

Objective: To evaluate the effects on the ligament of Marshall (LOM) potential by epicardial alcohol ablation of LOM in canine.Methods: Epicardial mapping of LOM was performed by a home-made comb-like mapping catheter in 19 normal dogs . Recording of LOM potential was carried out in 11 consecutive dogs . The chemical ablation was performed by injection of alcohol at the entrance of the LOM to the coronary sinus (CS) till the LOM potential disappeared , extra alcohol ablation given to the atrial entrance along the middle segment of the LOM if the potential did not disappeared.Results: The results showed that all the LOM potentials disappeared in the 11 dogs which epicardial alcohol ablations were performer to the LOMs. The ablations were given to the entrance of the LOM to the CS in 9 dogs,in which their bipolar epicardiogram were presented as a typical'V' shape. All the potentials disappeared. The ablations were given not only to their CS entrances but also to their atrial entrances along the middle segment of the LOM in another 2 dogs, in which their bipolar epicardiogram were presented as'Y' shape,so the LOM potentials disappeared. Conclusion: It is simple and safe for the alcohol ablation to LOM , and the success rate of ablation is high .