Sanchis J, Chorro F J, López-Merino V, Such L, Cerda M, Valentin V
Cardiology Department, Clinic University Hospital, Valencia, Spain.
Pacing Clin Electrophysiol. 1990 Jun;13(6):745-56. doi: 10.1111/j.1540-8159.1990.tb02101.x.
Transcatheter ablation of the sinoatrial node with radiofrequency energy (0.6 MHZ, 2.5-5 watts) was performed in 10 dogs under fluoroscopic monitoring and autonomic blockade. Sinus function was previously studied in terms of cycle length, recovery time and atrial activation pattern by catheter mapping. Several discharges (8-22) were applied for variable periods of time (maximum 1 minute). Sinus tachycardia and/or sinus arrest during ablation confirmed correct catheter position. Sinus rhythm was abolished in eight dogs. The ectopic rhythm was atrial in six and AV nodal in two dogs. Ectopic atrial cycle length and recovery time were longer than the baseline sinus values: 724 +/- 321 versus 509 +/- 147, P less than 0.05; 1103 +/- 775 versus 618 +/- 151, P less than 0.05 (values in msec). The study was repeated 10-14 days later in six dogs; three maintained the same atrial rhythm, one persisted in sinus rhythm, and one dog changed from atrial to sinus rhythm, whereas another changed from sinus to atrial rhythm. Gross findings revealed transmural lesions in all dogs, without perforation. Histology in chronic dogs showed sinus cell necrosis and its replacement by granulation tissue.
sinus function may be abolished by closed chest radiofrequency ablation.
在10只犬中,于透视监测和自主神经阻滞下,用射频能量(0.6兆赫,2.5 - 5瓦)行经导管窦房结消融术。术前通过导管标测从周期长度、恢复时间和心房激动模式方面研究窦房结功能。施加数次(8 - 22次)不同时长(最长1分钟)的放电。消融期间的窦性心动过速和/或窦性停搏证实导管位置正确。8只犬的窦性心律被消除。6只犬出现房性异位心律,2只犬出现房室结性异位心律。异位心房周期长度和恢复时间长于基线窦性值:分别为724±321毫秒对509±147毫秒,P<0.05;1103±775毫秒对618±151毫秒,P<0.05(单位为毫秒)。10 - 14天后对6只犬重复该研究;3只犬维持相同的房性心律,1只犬持续为窦性心律,1只犬从房性心律转变为窦性心律,而另1只犬从窦性心律转变为房性心律。大体检查发现所有犬均有透壁性病变,无穿孔。慢性期犬的组织学检查显示窦房结细胞坏死并被肉芽组织取代。
经胸射频消融可消除窦房结功能。