Wu T G, Lu Z Y
Department of Internal Medicine, Tongji Hospital, Tongji Medical University, Wuhan.
J Tongji Med Univ. 1992;12(4):237-42. doi: 10.1007/BF02887857.
To characterize and compare the pathologic, hemodynamic and electrocardiographic changes of both transcatheter laser and electrical energy on ventricle, 36 subendocardial myocardium lesions were induced at energy 60, 120 and 240 Joules by either transcatheter laser irradiation or electrical shock in 7 anesthetized dogs. The following results were observed: 1) Both laser and electrical ablation on myocardium created nonhomogeneous myocardium injury, but laser ablation caused mainly focal tissue vaporization and necrosis, while electrical shock induced widespread tissue degenerations; 2) Both laser and electrical induced-lesion dimensions increased parallel to the total dosage of energy; 3) Laser ablation caused mainly (90%) single ventricular premature beats and 86% of them occurred within the first minute after energy discharged, while ventricular tachycardias were found in any electrical energy groups; ventricular fibrillations occurring during laser and electrical ablation were 5% and 13% respectively (P < 0.01); 4) A decrease in aortic blood pressure and an increase in central venous pressure induced by laser ablation were significantly less than that produced by the same amount of electrical energy (P < 0.01). Our preliminary results have shown that transcatheter laser ablation has great potential for becoming a practical method in the management of refractory tachycardias.
为了描述和比较经导管激光与电能对心室的病理、血流动力学及心电图变化，在7只麻醉犬身上，分别通过经导管激光照射或电击，于能量60、120和240焦耳时造成36处心内膜下心肌损伤。观察到以下结果：1）激光和电击对心肌造成的损伤均不均匀，但激光消融主要引起局灶性组织汽化和坏死，而电击导致广泛的组织变性；2）激光和电击所致损伤的范围均随总能量剂量平行增加；3）激光消融主要引起（90%）单源性室性早搏，其中86%在能量释放后的第一分钟内出现，而在任何电能组中均发现室性心动过速；激光和电击消融过程中发生心室颤动的分别为5%和13%（P<0.01）；4）激光消融引起的主动脉血压下降和中心静脉压升高明显低于相同能量的电击所致（P<0.01）。我们的初步结果表明，经导管激光消融在治疗难治性心动过速方面很有潜力成为一种实用方法。
