在绵羊模型中，连续流左心室辅助装置植入后心房在心室颤动中的作用。
The role of atria in ventricular fibrillation after continuous-flow left ventricular assist device implantation in ovine model.
作者信息
Yu Xin-Yi, Shi Jian-Wei, Rong Yan-Sheng, Chen Yuan-Lu, Liu Tian-Wen, Zang Yi-Rui, Fu Ze-An, Zhang Jie-Min, Han Zhi-Fu, Liu Zhi-Gang
机构信息
Department of Cardiovascular Surgery, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.
Department of Anesthesiology, TEDA International Cardiovascular Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.
出版信息
Front Cardiovasc Med. 2023 Jan 9;9:1000352. doi: 10.3389/fcvm.2022.1000352. eCollection 2022.
OBJECTIVES
This study attempted to explore the hemodynamics and potential mechanisms driving pulmonary circulation in status of ventricular fibrillation (VF) following continuous-flow left ventricular assist device (CF-LVAD) implantation.
METHODS
An ovine CF-LVAD model was built in small-tailed Han sheep, with the pump speed set as 2,400 rpm. VF was induced following ventricular tachycardia using a temporary pacemaker probe to stimulate the right and left ventricular free walls. The central venous pressure (CVP), pump flow (PF), pulmonary artery flow (PAF) and other major indicators were observed and recorded after VF.
RESULTS
Low-flow systemic and pulmonary circulation could be sustained for 60 min under VF with sinus atrial rhythm after CF-LVAD implantation. The CVP gradually increased. The mean PF declined from 1.80 to 1.20 L/min, and the mean PAF decreased from 1.62 L/min to 0.87 L/min. Under VF with atrial fibrillation, the systemic and pulmonary circulation couldn't be sustained. The CVP jumped from the 5 mmHg baseline to 12 mmHg, the mean PF rapidly decreased from 3.45 L/min to 0.79 L/min, and the PAF declined from 3.94 L/min to 0.77 L/min.
CONCLUSION
The atrial rhythm and function might be essential for the circulation maintenance in patients with VF after CF-LVAD implantation.
目的
本研究试图探讨连续流左心室辅助装置（CF-LVAD）植入后心室颤动（VF）状态下肺循环的血流动力学及潜在驱动机制。
方法
在小尾寒羊中建立羊CF-LVAD模型，泵速设定为2400转/分钟。使用临时起搏器探头刺激右心室和左心室游离壁，在室性心动过速后诱发VF。VF发生后观察并记录中心静脉压（CVP）、泵流量（PF）、肺动脉流量（PAF）等主要指标。
结果
CF-LVAD植入后，在VF且伴有窦性心律的情况下，低流量的体循环和肺循环可维持60分钟。CVP逐渐升高。平均PF从1.80升/分钟降至1.20升/分钟，平均PAF从1.62升/分钟降至0.87升/分钟。在VF且伴有心房颤动的情况下，体循环和肺循环无法维持。CVP从5 mmHg的基线跃升至12 mmHg，平均PF从3.45升/分钟迅速降至0.79升/分钟，PAF从3.94升/分钟降至0.77升/分钟。
结论
心房节律和功能可能对CF-LVAD植入后VF患者的循环维持至关重要。
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