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低强度心房神经节丛刺激对心室电生理和心律失常发生的影响。

Effects of low-intensity atrial ganglionated plexi stimulation on ventricular electrophysiology and arrhythmogenesis.

机构信息

Department of Cardiology, Renmin Hospital of Wuhan University and Cardiovascular Research Institute of Wuhan University, PR China.

出版信息

Auton Neurosci. 2013 Mar;174(1-2):54-60. doi: 10.1016/j.autneu.2013.01.004. Epub 2013 Jan 31.

Abstract

BACKGROUND

Atrial ganglionated plexi (GP) have been shown to modulate sinus rate, atrioventricular conduction and atrial electrophysiology. The aim of this study was to investigate the effect of low-intensity GP stimulation (GPS) on ventricular electrophysiological properties in normal heart and on ventricular arrhythmogenesis after acute myocardial ischemia (AMI) in canine.

METHODS AND RESULTS

Thirty-nine dogs were assigned into the normal heart group (n=12) and the acute myocardial ischemia (AMI) group (n=27, 12 in control and 15 in low-intensity GPS). In the normal heart group, ventricular effective refractory period (ERP), dynamic restitution and electrical alternans were measured at baseline and after 6-hour low-intensity GPS. In the AMI group, the incidence of ventricular arrhythmias was determined during 1-hour recording after AMI was induced. In the normal heart, 6-hour low-intensity GPS significantly prolonged ventricular ERP and action potential duration (APD) at each site (all P<0.05) but did not change their spatial dispersions when compared with baseline. Low-intensity GPS also caused an upward shift of ventricular restitution curves in each site but did not change the slope of restitution curves. APD alternans after low-intensity GPS occurred at longer pacing cycle length at each site when compared with baseline (all P<0.05). In the AMI heart, the incidence of ventricular arrhythmias in low-intensity GPS group was significantly lower than that in control group (P<0.05).

CONCLUSIONS

Low-intensity GPS induces no increase in the risk of ventricular arrhythmias in the normal heart as well as protects against ventricular arrhythmogenesis during AMI.

摘要

背景

已证实,心房神经节丛(GP)可调节窦房结频率、房室传导和心房电生理。本研究旨在探讨低强度 GP 刺激(GPS)对正常心脏心室电生理特性的影响,以及在犬急性心肌缺血(AMI)后对心室心律失常发生的影响。

方法和结果

39 只狗被分为正常心脏组(n=12)和急性心肌缺血组(n=27,对照组 12 只,低强度 GPS 组 15 只)。在正常心脏组,在基线和低强度 GPS 后 6 小时测量心室有效不应期(ERP)、动态恢复和电交替。在 AMI 组,在诱导 AMI 后 1 小时记录期间确定室性心律失常的发生率。在正常心脏中,与基线相比,6 小时低强度 GPS 显著延长了每个部位的心室 ERP 和动作电位时程(APD)(均 P<0.05),但不改变它们的空间离散度。低强度 GPS 还导致每个部位的心室恢复曲线向上移位,但不改变恢复曲线的斜率。与基线相比,低强度 GPS 后 APD 交替在每个部位的起搏周期长度较长时发生(均 P<0.05)。在 AMI 心脏中,低强度 GPS 组的室性心律失常发生率明显低于对照组(P<0.05)。

结论

低强度 GPS 不会增加正常心脏中室性心律失常的风险,并且在 AMI 期间可防止室性心律失常的发生。

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