解放军医学杂志2012，Vol.37Issue(7)：691-694,4.
射频导管消融犬左束支电位对心脏电机械活动的影响
Effect of left bundle potential on cardiac electro-mechanical activity in dogs with radiofrequency catheter ablation
摘要
Abstract
Objective To investigate the effect of left bundle branch potential (LBP) on cardiac conduction and function in dogs with radiofrequency catheter ablation, and explore method for reproducing left bundle branch block (LBBB) model in dogs. Methods LBP was mapped and ablated by radiofrequency catheter in the left ventricular endocardium in 10 dogs to observe whether LBBB model was prepared successfully. Echocardiography was performed before and after LBBB in the successfully-prepared LBBB models to study the systolic and diastolic function of left ventricle. Resnlts After LBP ablation, LBBB was successfully created in 8 (80%) dogs. Atrial and ventricular amplitude ratio (A:V) was less than 1:10 at successful ablation site and the interval of LBP to local ventricular potential (LBP-V) was 17.1 ± 3.2ms (range from 12 to 22ms). The QRS duration was increased from 52.8 ± 4.8ms to 100.5± 11.1ms (P<0.001) after LBBB in these 8 dogs, but there were no significant changes in PR, AH and HV intervals after LBP ablation. In the remaining 1 dogs, a similar LBP potential was identified with LBP-V 30 and 32ms, but complete AV blocks were produced during or after RF energy application. In 8 LBBB dogs, echocardiography showed that systolic and diastolic functions all decreased, not only with reduced left ventricular ejection fraction (LVEF), aortic blood flow velocity time integral and E/A, but also with extended E wave deceleration time and isovolumetric relaxation time (P<0.05). Moreover, significant prolongation of septal-to-posterior wall motion delay and increased difference of pre-ejection time (P<0.001) denoted intraventricular and interventricular desynchronization after LBBB. Conclusion Radiofrequency catheter ablation of LBP could result in LBBB and might be an effective method for reproduction of canine LBBB model, although complete AV block might happen in few dogs. After LBBB, intraventricular and interventricular desynchronization and left ventricular electrical activation delay could immediately occur accompanied by decrease of cardiac systolic and diastolic functions.关键词
导管消融术/心脏传导阻滞/电生理学技术/心脏Key words
catheter ablation/ heart block/ electrophysiologic techniques, cardiac分类
医药卫生引用本文复制引用
付柳静,王冬梅,梁延春,于海波,李世倍,许国卿,王祖禄,韩雅玲..射频导管消融犬左束支电位对心脏电机械活动的影响[J].解放军医学杂志,2012,37(7):691-694,4.基金项目
辽宁省自然科学基金(22102250) （22102250）
沈阳军区总医院院重点基金(09Y-Z07) （09Y-Z07）
