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无创希氏束心电图在评估洋地黄对房室传导影响方面的适用性。

The applicability of noninvasive His bundle electrogram to assessing the effect of digitalis on atrioventricular conduction.

作者信息

Otsuka K, Otsuka K, Nojima K, Saito H, Seto K, Ozawa T

出版信息

Clin Cardiol. 1986 May;9(5):203-8. doi: 10.1002/clc.4960090507.

Abstract

His bundle electrograms were recorded by a signal averaging technique using the Takayasu vectorial lead system, and effects of ouabain on the atrioventricular conduction were investigated using Wistar rats. Ouabain was given intraperitoneally at 30 min intervals in doses of 1-40 mg/kg. When ouabain dosage was increased to 20 mg/kg, the prolongation of PQ interval became prominent and P waves were hidden on the preceding T waves. Dose-related prolongation of PQ and AH intervals was observed in the 1-15 mg/kg dosages. Ouabain-induced ventricular arrhythmias occurred in the 30 mg/kg dosage. Dose-related prolongation of QRS duration and HV interval was observed in the 1-25 mg/kg dosages. These prolongations were significant by the analysis of variance (p less than 0.01). Prolongation of PQ and AH intervals is probably due to a digitalis-induced increase in parasympathetic nerve activity. However, the reason for the prolongation of HV interval and QRS duration was uncertain. Direct effects of ouabain on the conduction system, or central nervous system effects of ouabain on cardiovascular function were speculated. These results suggest the applicability of the noninvasive record of His bundle electrogram to assessing the digitalis effect even on the human atrioventricular conduction.

摘要

采用信号平均技术,使用高田矢量导联系统记录希氏束电图,并以Wistar大鼠研究哇巴因对房室传导的影响。哇巴因以1 - 40mg/kg的剂量每隔30分钟腹腔注射一次。当哇巴因剂量增加到20mg/kg时,PQ间期延长变得显著,P波隐藏在前一个T波上。在1 - 15mg/kg剂量范围内观察到PQ和AH间期呈剂量相关延长。在30mg/kg剂量时出现哇巴因诱导的室性心律失常。在1 - 25mg/kg剂量范围内观察到QRS时限和HV间期呈剂量相关延长。经方差分析,这些延长具有显著性(p小于0.01)。PQ和AH间期延长可能是由于洋地黄引起的副交感神经活动增加。然而,HV间期和QRS时限延长的原因尚不确定。推测是哇巴因对传导系统的直接作用,或者是哇巴因对心血管功能的中枢神经系统作用。这些结果表明,希氏束电图的无创记录可用于评估洋地黄对人体房室传导的影响。

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