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心肌缺血对左回旋支冠状动脉内和心外膜心肌起搏阈值的影响 预览

The effect of myocardial ischemin on the transcoronary and transmyocardial pacing threshold
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摘要 目的观察心肌缺血对兔左回旋支(LCX)冠状动脉内和心外膜心肌起搏阈值的影响。方法将20只健康家兔随机分为A、B两组。于LCX中点以远3—5mm处钩置临时起搏导丝(深度:A组至LCX内,B组至LCX以下1—2mm的肌层)。结扎LCX中点,建立兔心肌梗死模型,观察结扎前及结扎180min内两组起搏阈值。结果A、B两组基础起搏阈值分别为(0.82±0.12)V和(0.80±0.12)V,差异无统计学意义(P〉0.05)。与基础起搏阈值相比,两组结扎后各时间点起搏阈值均明显增高,分别为(4.37±0.59)V和(3.97±0.96)V(P〈0.05)。结扎前20min,两组起搏阈值变化趋势相似;结扎10min均急剧增高(P〉0.05);结扎20min均明显回落,分别为(2.13±0.59)V和(1.89±0.75)V(P〉0.05)。自此至结扎3h,A组起搏阙值保持该水平不变(P〉0.05),B组则逐渐增高,与A组相比,差异有统计学意义[(6.86±1.65)V比(1.60±0.62)V,P〈0.05]。结论心肌缺血导致兔LCX冠状动脉内和心外膜心肌起搏阈值均明显增高。缺血20—180min,心外膜心肌起搏阈值持续升高,但LCX冠状动脉内起搏阈值维持在基础起搏阈值的2倍水平,均在可起搏频率内。 Objective To discuss the effect of myocardial ischemia on the transcoronary and transmyocardial pacing threshold based on rabbit myocardial infarction models. Methods 20 rabbits were randomly assigned into group A and group B. The temporary pacing wire was hooked transcoronarily in group A and transmyocardialy in group B, 3 -5 mm far from the middle point of LCX ligation. Pacing thresholds were measured after the ligation respectively within 180 minutes. Results The pacing threshold at baseline in group A and B were (0. 82 ± 0. 1.2) V and (0. 80 ± 0. 12) V ( P 〉 0. 05 ), respectively. The pacing thresholds of the two groups changed significantly after ischemia (vs. baseline,P 〈0. 05), which increased to (4.37 ±0.59) V and (3.97 ±0.96) V at the 10th minute, but decreased to (2. 13 ±0.59) V and ( 1.89 ± 0. 75) V at the 20th minutes. Over the following 3 hours, the pacing thresholds remained similar level in group A ( vs. 20rain, P 〉 0. 05 ), while graduallyincreased to ( 6. 86 ± 1.65 ) V in group B ( vs. group A, P 〈 0. 05 ). Conclusions The transcoronary and transmyocardial pacing threshold were both raised after the myocardial ischemia. Although themyocardial ischemia within 20 - 180 minutes lead to an increase of transmyocardial pacing threshold constantly, the relatively stable transcoronary pacing still can be taken into account to assure effective pacing.
作者 侯倩 崔炜 谢瑞芹 王欢 刘静 呼海娟 HOU Qian, CUI Wei, XIE Rui-qin, WANG Huan, LIU Jing, HU Hai-juan. Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
出处 《中国介入心脏病学杂志》 2013年第3期184-187,共4页 Chinese Journal of Interventional Cardiology
关键词 心肌缺血 冠状血管 心外膜 心脏起搏器 人工 Myocardial ischemia Coronary vessels Pericardium Pacemaker, artificial Rabbits
作者简介 通信作者:崔炜,Email:cuiwei@medmail.com.cn
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