Qi X Q, Sun R L, Tang C J, Wang F Z, Ruan Y M, Gao R L, Li Y L, Tao S Q, Cai R S
Cardiovascular Institute, Chinese Academy of Medical Sciences, Beijing.
Chin Med J (Engl). 1991 Aug;104(8):639-44.
Thirty-seven reproducible ventricular tachycardias (VTs) were induced in 19 dogs after the onset of myocardial infarction. The site of origin of VT was localized in 19 (59%) of 32 VTs by ice epicardial mapping. After 0.3-1.2 ml of 95% ethanol was injected into a small coronary artery supplying the arrhythmogenic area, VT was no longer inducible in 10 of 14 dogs. Intramyocardial ethanol (1-3 ml) was injected into the site of origin of VT in 9 dogs including 4 with VTs reinduced after intracoronary ethanol. Six of these VTs were not reinduced. Thus, the total efficacy rate was 84%. In 7 dogs, after injection of 0.4-1.2 ml (mean 0.5 ml) of 95% ethanol into a small normal coronary artery, the extent of the changes in ECG, CK-MB and pathology was found to be related to the size of myocardial damage and to the dose of ethanol. The smaller the dose of ethanol was given and the more distal the branch of coronary artery into which the ethanol was injected, the smaller the myocardial damage was. The data demonstrated that intracoronary or intramyocardial injection of ethanol may ablate the experimental VT induced by programmed heart stimulation in dogs after myocardial infarction, indicating that this approach may be useful and meaningful in some selected instances. However, it is necessary to limit the myocardial damage as far as possible.
在19只犬发生心肌梗死后诱发了37次可重复的室性心动过速（VT）。通过心外膜冷冻标测，在32次VT中的19次（59%）确定了VT的起源部位。向供应心律失常起源区域的一条小冠状动脉内注射0.3 - 1.2 ml 95%乙醇后，14只犬中有10只不再能诱发VT。对9只犬，包括4只冠状动脉内注射乙醇后VT再次诱发的犬，在VT起源部位注射心肌内乙醇（1 - 3 ml）。其中6次VT未再被诱发。因此，总有效率为84%。在7只犬中，向一条小的正常冠状动脉内注射0.4 - 1.2 ml（平均0.5 ml）95%乙醇后，发现心电图、肌酸激酶同工酶（CK - MB）和病理学改变的程度与心肌损伤大小及乙醇剂量有关。给予的乙醇剂量越小且乙醇注入的冠状动脉分支越靠远端，心肌损伤越小。数据表明，冠状动脉内或心肌内注射乙醇可消除心肌梗死后犬经程序心脏刺激诱发的实验性VT，提示该方法在某些特定情况下可能是有用且有意义的。然而，有必要尽可能限制心肌损伤。
