Tjomsland O, Grund F, Kanellopoulos G K, Kvernebo K, Ilebekk A
Department of Cardiovascular Surgery, Ullevaal HospItal, University of Oslo, Norway.
J Cardiovasc Surg (Torino). 2000 Oct;41(5):675-82.
It has previously been shown that transmyocardial revascularization with laser (TMR) prior to coronary artery occlusion decreases the occurrence of ischemia-induced arrhythmias. The aim of the present study was to determine the effects of TMR on ventricular fibrillation and other arrhythmias during the early (1a) and late phase (1b) of ischemia in pigs.
In six pigs TMR was performed in the anterior wall of the left ventricle 60 minutes prior to occlusion of the proximal LAD. Six other pigs were subjected to coronary occlusion without preceding TMR and served as controls.
During the 30 min period with LAD occlusion ventricular fibrillation occurred 22 times in 5 of 6 control animals (20 episodes in phase la, 2 in phase 1b), whereas none of the animals subjected to TMR prior to the coronary artery occlusion developed ventricular fibrillation (p<0.01). The total number of premature beats per animal was lower during the early phase (la) after LAD occlusion in the TMR group than in the control group (18+/-13 vs 248+/-82, p<0.05).
TMR prior to occlusion of LAD reduced the occurrence of early phase (la) ischemia-induced ventricular fibrillation and premature beats. This anti-fibrillatory effect might explain the improved survival observed in experimental studies after TMR prior to coronary artery occlusion found by others.
先前的研究表明，在冠状动脉闭塞之前进行激光心肌血运重建术（TMR）可减少缺血性心律失常的发生。本研究的目的是确定TMR对猪缺血早期（1a期）和晚期（1b期）心室颤动及其他心律失常的影响。
对6头猪在结扎左前降支近端前60分钟，于左心室前壁进行TMR。另外6头猪在未先行TMR的情况下进行冠状动脉结扎，作为对照。
在结扎左前降支的30分钟期间，6只对照动物中有5只发生了22次心室颤动（1a期20次发作，1b期2次），而在冠状动脉闭塞前接受TMR的动物中没有一只发生心室颤动（p<0.01）。TMR组在结扎左前降支后的早期（1a期），每只动物的早搏总数低于对照组（18±13对248±82，p<0.05）。
在结扎左前降支之前进行TMR可减少早期（1a期）缺血性心室颤动和早搏的发生。这种抗颤动作用可能解释了其他人在冠状动脉闭塞前进行TMR的实验研究中观察到的生存率提高的现象。
