Pang Yang, Jin Qi, Zhang Ning, Ren Shujing, Ling Tianyou, Chen Ying, Gu Gang, Shen Yongchu, Wu Liqun
Department of Cardiology, Shanghai Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, No.197, Rui-Jin Er Road, 200025, Shanghai, People's Republic of China.
J Interv Card Electrophysiol. 2011 Nov;32(2):81-6. doi: 10.1007/s10840-011-9589-6. Epub 2011 Jun 15.
This study evaluated the effects of shock energy on the dispersion of regional ventricular repolarization (DRVR), post-shock rhythm and sinus recovery time (SRT), and the relationship between DRVR and post-shock ventricular arrhythmias.
Ten open-chest dogs were anesthetized. Ventricular fibrillation (VF) was electrically induced and recorded from a 6 × 6 unipolar electrode plaque (4 mm spacing) sutured on the left ventricular epicardium. Defibrillation threshold (DFT) was determined after 20 s of VF. DRVR was measured before VF, during the earliest post-shock sinus rhythm, and during sinus rhythm 30 s following shocks. Post-shock rhythm and SRT were evaluated after energies of 100% DFT, 125% DFT, 175% DFT, and 250% DFT.
In the100% DFT group, the DRVR of the earliest sinus rhythm and 30 s after successful defibrillation was not significantly different than that before VF. But the DRVRs were significantly increased in 125% DFT, 175% DFT, and 250% DFT group. DRVR after defibrillation in the 250% DFT group was higher than those in the 100% DFT and 125% DFT groups. SRT in the 250% DFT group was significantly longer than that in the other groups .The incidence of post-shock ventricular tachycardia was increased when a high-shock energy was applied (P = 0.041).
DRVR was increased by application of high-energy defibrillation associated with SRT prolongation. The increased DRVR may play an important role in the onset of post-shock ventricular tachycardia.
本研究评估了电击能量对局部心室复极离散度（DRVR）、电击后心律和窦房结恢复时间（SRT）的影响，以及DRVR与电击后室性心律失常之间的关系。
对10只开胸犬进行麻醉。通过电刺激诱发心室颤动（VF），并从缝合在左心室心外膜上的6×6单极电极片（间距4mm）记录。在VF持续20秒后测定除颤阈值（DFT）。在VF前、电击后最早的窦性心律期间以及电击后30秒的窦性心律期间测量DRVR。在100% DFT、125% DFT、175% DFT和250% DFT的能量下评估电击后心律和SRT。
在100% DFT组中，最早窦性心律和成功除颤后30秒的DRVR与VF前无显著差异。但在125% DFT、175% DFT和250% DFT组中，DRVR显著增加。250% DFT组除颤后的DRVR高于100% DFT和125% DFT组。250% DFT组的SRT显著长于其他组。高电击能量应用时，电击后室性心动过速的发生率增加（P = 0.041）。
高能量除颤导致DRVR增加，同时伴有SRT延长。DRVR的增加可能在电击后室性心动过速的发生中起重要作用。
