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[各向异性与折返性室性心动过速:离体兔心实验模型]

[Anisotropy and reentrant ventricular tachycardia: experimental model in the isolated rabbit heart].

作者信息

Brugada J, Boersma L, Kirchhof C, Allessie M

机构信息

Departamento de Fisiologia, Universidad de Limburg, Maastricht, Holanda.

出版信息

Rev Esp Cardiol. 1990 Oct;43(8):558-68.

PMID:2099516
Abstract

The purpose of this study was to study the role of anisotropic distribution of conduction velocity in the initiation and perpetuation of ventricular tachycardia in an experimental model of sustained reentrant ventricular tachycardia in the Langendorff perfused rabbit heart. The hearts of 30 rabbits were used in the study. The right ventricle, the interventricular septum and the endocardial and intramural layers of the left ventricle were destroyed by freezing. In the surviving epicardial layer an obstacle was created using a cryoprobe. Thus, the final preparation consisted of a perfused ring of epicardium in the left ventricle. In 27 of 30 experiments programmed electrical stimulation induced sustained reentrant excitation around the obstacle. The cycle length of the tachycardia ranged from 128 to 197 ms in different experiments (mean 162 +/- 17 ms). During tachycardia in some segments of the ring the impulse propagated parallel to fiber orientation at a mean conduction velocity of 61 +/- 7 cm/s whereas in other segments of the ring the impulse propagated perpendicular to fiber orientation at a mean conduction velocity of 22 +/- 4 cm/s. An excitable gap was present during all episodes of tachycardia. In conclusion, conduction velocity during reentrant tachycardia depends on the relation between direction of propagation and fiber orientation. This anisotropic distribution of conduction velocity can play an important role in the initiation and perpetuation of ventricular tachycardia.

摘要

本研究的目的是在Langendorff灌注兔心脏持续性折返性室性心动过速的实验模型中,研究传导速度的各向异性分布在室性心动过速的起始和持续中的作用。本研究使用了30只兔子的心脏。通过冷冻破坏右心室、室间隔以及左心室的心内膜和心肌层。在存活的心外膜层中,使用冷冻探头制造一个障碍。因此,最终的标本是左心室的心外膜灌注环。在30个实验中的27个实验中,程控电刺激在障碍周围诱发了持续性折返激动。不同实验中,心动过速的周长在128至197毫秒之间(平均162±17毫秒)。在心动过速期间,环的某些节段中冲动平行于纤维方向传播,平均传导速度为61±7厘米/秒,而在环的其他节段中,冲动垂直于纤维方向传播,平均传导速度为22±4厘米/秒。在所有心动过速发作期间均存在可兴奋间隙。总之,折返性心动过速期间的传导速度取决于传播方向与纤维方向之间的关系。这种传导速度的各向异性分布在室性心动过速的起始和持续中可发挥重要作用。

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