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射频导管消融犬左束支电位对心脏电机械活动的影响
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射频导管消融犬左束支电位对心脏电机械活动的影响
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Journal Article
射频导管消融犬左束支电位对心脏电机械活动的影响
2012
Overview
目的探讨射频导管消融犬左束支电位（LBP）对心脏传导及心功能的影响,以及犬左束支传导阻滞（LBBB）模型的制备方法。方法应用射频消融导管在10只实验犬左心室内膜标测到LBP处进行消融,观察能否成功制备犬LBBB模型以及其对心脏传导的影响。对成功复制LBBB的模型犬应用超声心动图比较LBBB前后心脏收缩功能及舒张功能的变化。结果 10只犬接受LBP处消融后,8只（80%）成功制备LBBB模型。消融靶点处心房与心室电压比值〈1：10,局部记录的LBP至心室电位间期为17.1±3.2（12-22）ms,消融后QRS波宽度由52.8±4.8ms增至100.5±11.1ms（P〈0.001）,而PR间期、AH间期、HV间期无明显变化。另外2只犬在LBP至心室电位间期分别为30ms、32ms处消融,导致完全性房室传导阻滞。8只犬发生LBBB后超声心动图检查示：收缩功能指标左室射血分数和主动脉血流速度积分降低（P〈0.05）;舒张功能指标E/A下降为〈1,伴有等容舒张时间和二尖瓣减速时间延长（P〈0.05）;出现显著室间与室内不同步,表现为间隔后壁运动延迟及左右心室射血前期时间差明显延长（P〈0.001）。结论射频导管消融左束支电位可导致LBBB,是制备犬LBBB模型成功率较高的方法,但有发生完全性房室传导阻滞的危险。LBBB即刻可导致左室激动延迟,左右室间及左室内收缩不同步,左心室收缩及舒张功能降低。
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