Denniss A R, Richards D A, Waywood J A, Yung T, Kam C A, Ross D L, Uther J B
Department of Medicine, Westmead Hospital, Sydney, Australia.
Circ Res. 1989 Jan;64(1):155-66. doi: 10.1161/01.res.64.1.155.
This study examined electrophysiological and anatomic differences between dogs with ventricular tachycardia (VT) and fibrillation (VF) inducible by programmed ventricular stimulation 7-21 days after left anterior descending coronary artery ligation. Of 106 dogs studied, 40 had inducible VT, 19 had inducible VF, and 47 had no inducible arrhythmias. Differences between these three groups of animals were examined with cardiac mapping (to determine ventricular activation time in sinus rhythm) and post-mortem pathology (to measure infarct size and to reconstruct the anatomy at the infarct edge). Animals with inducible VT had longer maximal epicardial activation time (127 +/- 8 msec) than did animals with inducible VF (91 +/- 8 msec, p less than 0.05) or animals with no inducible arrhythmias (75 +/- 2 msec, p less than 0.001). Delayed epicardial activation occurred in 90% of animals with VT, 42% of animals with VF, and in only 6% of animals with no inducible arrhythmias. Endocardial and myocardial activation times were similar for the VT and VF groups. Infarct size was 18 +/- 2% of the ventricles for the VT group, much higher than for the VF group (11 +/- 2%, p less than 0.001) or for the group with no inducible arrhythmias (9 +/- 1%, p less than 0.001). The maximum diameter of viable muscle bundles interdigitating with scar tissue at the infarct edge was much larger in animals with VT (2.4 +/- 0.2 mm) than in animals with VF (1.8 +/- 0.2 mm, p less than 0.05) or animals with no inducible arrhythmias (1.7 +/- 0.1 mm, p less than 0.01). Thus, when compared with animals with inducible VF, animals with inducible VT had longer epicardial activation time, larger infarct size and viable muscle bundles of larger diameter at the infarct edge.
本研究检测了在左前降支冠状动脉结扎7 - 21天后经程序性心室刺激可诱发室性心动过速（VT）和室颤（VF）的犬之间的电生理和解剖学差异。在研究的106只犬中，40只可诱发VT，19只可诱发VF，47只未诱发心律失常。通过心脏标测（以确定窦性心律时的心室激动时间）和尸检病理学（以测量梗死面积并重建梗死边缘的解剖结构）来检测这三组动物之间的差异。可诱发VT的动物的最大心外膜激动时间（127±8毫秒）比可诱发VF的动物（91±8毫秒，p<0.05）或未诱发心律失常的动物（75±2毫秒，p<0.001）更长。90%的VT动物、42%的VF动物出现心外膜激动延迟，而未诱发心律失常的动物中只有6%出现。VT组和VF组的心内膜和心肌激动时间相似。VT组的梗死面积占心室的18±2%，远高于VF组（11±2%，p<0.001）或未诱发心律失常的组（9±1%，p<0.001）。在梗死边缘与瘢痕组织交错的存活肌束的最大直径，VT动物（2.4±0.2毫米）比VF动物（1.8±0.2毫米，p<0.05）或未诱发心律失常的动物（1.7±0.1毫米，p<0.01）大得多。因此，与可诱发VF的动物相比，可诱发VT的动物的心外膜激动时间更长，梗死面积更大，梗死边缘存活肌束的直径更大。
