Reek S, Geller J C, Klein H U, Dietzmann K, Ideker R E
Klinik für Kardiologie, Angiologie und Pneumologie, Zentrum für Innere Medizin, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany.
Z Kardiol. 2004 Apr;93(4):278-86. doi: 10.1007/s00392-004-0046-8.
The study describes the electrophysiological effects of transvenous cardiac nerve stimulation in an animal model of myocardial infarction. In ten sheep with recent myocardial infarction, transvenous stimulation of parasympathetic cardiac nerves was achieved from a catheter in the right pulmonary artery. The effects of transvenous cardiac nerve stimulation on sinus rhythm cycle length, ventricular refractory periods and inducibility of monomorphic ventricular tachycardia were evaluated. Sinus rhythm cycle length increased from 620 +/- 24 ms to 723 +/- 30 ms during nerve stimulation with 20 Hz and to 779 +/- 28 ms during stimulation with 40 Hz (p < 0.05). Effective ventricular refractory periods from stimulation sites in non-infarcted right and left ventricular myocardium showed a tendency towards prolongation during cardiac nerve stimulation with shortening after cessation of stimulation. These differences, however, were not significant. In contrast, refractory periods from stimulation sites within the infarcted area remained unchanged during cardiac nerve stimulation. The inducibility of monomorphic ventricular tachycardia by programmed electrical stimulation was reduced during transvenous cardiac nerve stimulation. Pathological examination showed cholinergic nerves in close proximity to the tip of the stimulation catheter in the right pulmonary artery. Transvenous cardiac nerve stimulation in sheep with remote myocardial infarction exhibits electrophysiological effects on the ventricles. Although a parasympathetic effect on the ventricles could not be proven, the observed effects may result from direct stimulation of efferent parasympathetic nerves.
该研究描述了经静脉心脏神经刺激在心肌梗死动物模型中的电生理效应。在十只近期发生心肌梗死的绵羊中，通过右肺动脉内的导管实现了对心脏副交感神经的经静脉刺激。评估了经静脉心脏神经刺激对窦性心律周期长度、心室不应期和单形性室性心动过速诱发率的影响。在20Hz神经刺激期间，窦性心律周期长度从620±24ms增加到723±30ms，在40Hz刺激期间增加到779±28ms（p<0.05）。来自非梗死右心室和左心室心肌刺激部位的有效心室不应期在心脏神经刺激期间有延长趋势，刺激停止后缩短。然而，这些差异并不显著。相比之下，梗死区域内刺激部位的不应期在心脏神经刺激期间保持不变。经静脉心脏神经刺激期间，程序性电刺激诱发单形性室性心动过速的诱发率降低。病理检查显示右肺动脉内刺激导管尖端附近有胆碱能神经。对患有陈旧性心肌梗死的绵羊进行经静脉心脏神经刺激对心室具有电生理效应。虽然未证实对心室有副交感效应，但观察到的效应可能是由于直接刺激传出副交感神经所致。
