Gao Mei, Zhang Ling, Scherlag Benjamin J, Huang Bing, Stavrakis Stavros, Hou Yue-Mei, Hou Yinglong, Po Sunny S
Department of Cardiology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China.
Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Heart Rhythm. 2015 Apr;12(4):818-24. doi: 10.1016/j.hrthm.2014.12.024. Epub 2014 Dec 19.
Atrial fibrillation (AF) is highly associated with obstructive sleep apnea (OSA) in which AF is triggered by hyperactivity of the cardiac autonomic nervous system. Previous studies showed that low-level vagosympathetic trunk stimulation (LLVS), at voltages not slowing sinus rate or AV conduction, inhibits AF by suppressing the cardiac autonomic nervous system.
The purpose of this study was to investigate whether LLVS delivered at the right vagosympathetic trunk suppresses AF in a rabbit model of OSA.
Eleven rabbits received a tracheostomy under general anesthesia. The endotracheal tube was clamped at end expiration for 1 minute to simulate OSA. Over a period of 4 hours, OSA was delivered every 6 minutes. Effective refractory period (ERP), blood pressure, intraesophageal pressure, and blood gases (O2, CO2, pH) were measured before and after each episode of OSA. AF duration and ERP were measured by programmed stimulation. Group 1 rabbits (n = 6) received LLVS (50% below that which slowed the sinus rate) in the first 3 hours. Group 2 rabbits (n = 5) only received OSA.
Group 1 ERP began to lengthen progressively from the second hour compared to group 2. AF duration increased in the first hour for both groups but began to shorten progressively after the first hour in group 1 rabbits. Blood pH, O2 or CO2 level, intraesophageal pressure, and hypertensive response during OSA were not different between the 2 groups.
LLVS is capable of suppressing ERP shortening and AF induced by OSA. LLVS may serve as a new therapeutic approach to treat OSA-induced AF.
心房颤动（AF）与阻塞性睡眠呼吸暂停（OSA）高度相关，其中AF由心脏自主神经系统的过度活动引发。先前的研究表明，低水平迷走交感干刺激（LLVS）在不降低窦性心率或房室传导的电压下，通过抑制心脏自主神经系统来抑制AF。
本研究的目的是调查在兔OSA模型中，右侧迷走交感干给予LLVS是否能抑制AF。
11只兔子在全身麻醉下接受气管切开术。在呼气末夹住气管插管1分钟以模拟OSA。在4小时内，每6分钟给予一次OSA。在每次OSA发作前后测量有效不应期（ERP）、血压、食管内压和血气（O2、CO2、pH）。通过程控刺激测量AF持续时间和ERP。第1组兔子（n = 6）在最初3小时接受LLVS（比减慢窦性心率的电压低50%）。第2组兔子（n = 5）仅接受OSA。
与第2组相比，第1组ERP从第2小时开始逐渐延长。两组AF持续时间在第1小时均增加，但第1组兔子在第1小时后开始逐渐缩短。两组之间OSA期间的血pH、O2或CO2水平、食管内压和高血压反应无差异。
LLVS能够抑制OSA诱导的ERP缩短和AF。LLVS可能成为治疗OSA诱导的AF的一种新的治疗方法。
