Departments of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA.
Pacing Clin Electrophysiol. 2023 Aug;46(8):1003-1009. doi: 10.1111/pace.14765. Epub 2023 Jun 28.
The canine sterile pericarditis model associated with atrial inflammation is an experimental counterpart of postoperative atrial fibrillation (POAF). However, the use of canines for research is restricted by ethics committees in many countries, and social acceptance is declining.
To validate the feasibility of the swine sterile pericarditis model as an experimental counterpart to study POAF.
Seven domestic pigs (35-60 kg) underwent initial pericarditis surgery. On two or more postoperative days in the closed-chest state, we performed electrophysiological measurements of pacing threshold and atrial effective refractory period (AERP) while pacing from the right atrial appendage (RAA) and the posterior left atrium (PLA). The inducibility of POAF (>5 min) by burst pacing was determined in both the conscious and anesthetized closed-chest state. These data were compared to previously published canine sterile pericarditis data for validation.
The pacing threshold increased from day 1 to day 3 (2 ± 0.1 to 3.3 ± 0.6 mA in the RAA, 2.5 ± 0.1 to 4.8 ± 0.2 mA in the PLA). Also, the AERP increased from day 1 to day 3 (118 ± 8 to 157 ± 16 ms in the RAA; 98 ± 4 to 124 ± 2 ms in the PLA, both p < .05). Induction of sustained POAF occurred in 43% (POAF CL range 74-124 ms). All electrophysiologic data from the swine model were consistent with the canine model with respect to (1) the range of both pacing threshold and AERP; (2) the progressive increase in threshold and AERP over time; (3) a 40%-50% incidence of POAF.
A newly developed swine sterile pericarditis model demonstrated electrophysiologic properties consistent with the canine model and patients after open heart surgery.
与心房炎症相关的犬无菌性心包炎模型是术后心房颤动(POAF)的实验对应物。然而,由于许多国家的伦理委员会的限制以及社会接受度的下降,犬类在研究中的应用受到了限制。
验证猪无菌性心包炎模型作为 POAF 研究实验对应物的可行性。
7 只国内猪(35-60kg)接受了初始心包炎手术。在关胸状态下的 2 天或更多天,我们在心耳(RAA)和左心房后壁(PLA)进行起搏时,对起搏阈值和心房有效不应期(AERP)进行了电生理测量。在清醒和麻醉的关胸状态下,通过爆发起搏确定 POAF(>5min)的诱导性。将这些数据与之前发表的犬无菌性心包炎数据进行比较以验证。
起搏阈值从第 1 天到第 3 天增加(RAA 中从 2±0.1mA 增加到 3.3±0.6mA,PLA 中从 2.5±0.1mA 增加到 4.8±0.2mA)。同样,AERP 从第 1 天到第 3 天增加(RAA 中从 118±8ms 增加到 157±16ms;PLA 中从 98±4ms 增加到 124±2ms,均 p<0.05)。持续性 POAF 的诱导发生率为 43%(POAF CL 范围 74-124ms)。猪模型的所有电生理数据在以下方面与犬模型和心脏手术后的患者一致:(1)起搏阈值和 AERP 的范围;(2)随时间的进展,阈值和 AERP 逐渐增加;(3)POAF 的发生率为 40%-50%。
新开发的猪无菌性心包炎模型表现出与犬模型和心脏手术后患者一致的电生理特性。