Ma Ning, Fu Xiang-Hua
The 2nd Affiliated Hospital of Hebei Medical University, Shijiazhuang 050000, China.
Zhongguo Ying Yong Sheng Li Xue Za Zhi. 2002 Feb;18(1):71-4.
To evaluate the effects of atria-His bundle sequential pacing on cardiac electrophysiology and heamodynamics in dogs.
In 20 opening chest anesthetized dogs, platinum electrodes were fixed at the epicardium of right atria (RA) and the right ventricular apex (RVA) respectively, pacing right atria and the right ventricle. A special lead was located at His bundle (based on a optical "H" wave and narrow duration of the QRS complexes recorded in ECG), pacing His bundle. Cardiac electrophysiology and hemodynamics parameters were compared in the different pacing models RA(AAI, RVA-(VVI), HisB-(VVI) single chamber pacing and RA-RVA(DDI), RA-HisB(DDI) dual chamber pacing.
The threshold of His B pacing is similar to that of RVA pacing. Cardiac output (CO) is increased in pacing of RA(AAI), His B-(VVI) and RA-His B(DDI). It is increased by 29.64% in pacing of RA-His B(DDI) (P < 0.01) and by 0.25% (P > 0.05) in pacing of RA-RVA(DD1) While CO is decreased by 5.41% in RVA-VVI) pacing (P > 0.05). SV, LVSW and RVSW of RA-HisB(DDI) pacing are superior to those in RVA-VVI) and RA-RVA(DDI) pacing.
Right atria-His bundle sequence pacing significantly improves cardiac function compared with the other model pacing because it maintains normal physiological electronic activity sequence and systolic synchrony. It will be adapted to clinical application.
评估心房 - 希氏束顺序起搏对犬心脏电生理和血流动力学的影响。
在20只开胸麻醉犬中,将铂电极分别固定于右心房(RA)心外膜和右心室心尖(RVA),进行右心房和右心室起搏。通过一根特殊导联置于希氏束(基于心电图记录的光学“H”波和窄QRS波群时限),进行希氏束起搏。比较不同起搏模式下的心脏电生理和血流动力学参数,包括RA(AAI)、RVA - (VVI)、HisB - (VVI)单腔起搏以及RA - RVA(DDI)、RA - HisB(DDI)双腔起搏。
希氏束起搏阈值与右心室起搏阈值相似。RA(AAI)、HisB - (VVI)和RA - HisB(DDI)起搏时心输出量(CO)增加。RA - HisB(DDI)起搏时CO增加29.64%(P < 0.01),RA - RVA(DD1)起搏时增加0.25%(P > 0.05),而RVA - VVI起搏时CO降低5.41%(P > 0.05)。RA - HisB(DDI)起搏的每搏输出量(SV)、左心室搏功(LVSW)和右心室搏功(RVSW)优于RVA - VVI和RA - RVA(DDI)起搏。
与其他模式起搏相比,右心房 - 希氏束顺序起搏显著改善心脏功能,因为它维持了正常的生理电活动顺序和收缩同步性。它将适用于临床应用。