Auricchio A, Klein H, Trappe H J, Salo R
Department of Cardiology, University Hospital Hannover, Germany.
Pacing Clin Electrophysiol. 1992 Mar;15(3):344-56. doi: 10.1111/j.1540-8159.1992.tb06504.x.
In ten patients undergoing catheter ablation of the atrioventricular junction (CAVJ) because of therapy refractoriness of supraventricular arrhythmias, the effect of repeated high energy direct current (DC) shock on left ventricular function has been investigated. End-systolic pressure-volume relation (ESPVR) and the positive first derivative of ventricular pressure (dP/dt) have been used as indices of left ventricular systolic function, while the time constant of isovolumic pressure decay, the diastolic stiffness, and the negative dP/dt represented the diastolic function parameters, respectively. Each patient received at least two and no more than three DC shocks for successful CAVJ, with an energy of 360 joules. Significant acute reduction of both systolic and diastolic function was noted after each DC shock, with a slow partial recovery of both phases. The recovery process involved the systolic phase earlier and more completely than the diastolic one. The alterations observed could not be predicted from preablation values, but were significantly related to cumulative energy dose index for body weight. In conclusion, repeated high energy DC shocks acutely, but reversibly, impair left ventricular function; in addition, the ventricular function reduction is primarily related to the total ablation energy indexed for body weight.
在10例因室上性心律失常治疗难治而接受房室结导管消融（CAVJ）的患者中，研究了重复高能量直流电（DC）电击对左心室功能的影响。收缩末期压力-容积关系（ESPVR）和心室压力的正一阶导数（dP/dt）被用作左心室收缩功能的指标，而等容压力衰减的时间常数、舒张硬度和负dP/dt分别代表舒张功能参数。为成功进行CAVJ，每位患者接受至少两次且不超过三次能量为360焦耳的DC电击。每次DC电击后均观察到收缩和舒张功能的显著急性降低，两个阶段均有缓慢的部分恢复。恢复过程中收缩期比舒张期更早且更完全。观察到的改变无法根据消融前的值预测，但与体重的累积能量剂量指数显著相关。总之，重复高能量DC电击会急性但可逆地损害左心室功能；此外，心室功能降低主要与按体重计算的总消融能量有关。
