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[缺血性室内传导阻滞]

[Intraventricular conduction block induced by ischemia].

作者信息

Bisteni A, Marín J A, González C

出版信息

Arch Inst Cardiol Mex. 1984 Jul-Aug;54(4):309-20.

PMID:6497494
Abstract

The electrical consequences of experimental acute myocardial ischemia were studied in 50 dogs. The study was performed through unipolar epicardial leads and at different levels of the conducting system; bundle branch and Purkinje fibers. There is evidence that the block takes place at the Purkinje-muscle union or in the muscle-muscle conduction. In none of the experiments the block appeared in any of the components of the conducting system. Also, there is evidence that with severe ischemia muscle recordings disappeared while the Purkinje potentials remained unchanged, this suggests that conducting system cells are more resistant to hypoxia than the contractile cells. Ventricular arrhythmias usually appeared simultaneously with conduction blocks that favored reentries. Arrhythmias were more frequent when the blocks were more accentuated. Our data demonstrates that the conduction disorder precedes in some instances, the positive RS-T displacement and in others it hides the such displacement. It is concluded that the RS-T displacement, the distal conduction block and arrhythmias are manifestations, at different levels, of partial diastolic depolarization induced by acute myocardial ischemia.

摘要

在50只犬身上研究了实验性急性心肌缺血的电生理后果。该研究通过单极心外膜导联并在传导系统的不同水平进行,即束支和浦肯野纤维。有证据表明阻滞发生在浦肯野纤维与心肌的连接处或心肌与心肌的传导中。在任何实验中,传导系统的任何成分均未出现阻滞。此外,有证据表明,在严重缺血时,心肌记录消失而浦肯野电位保持不变,这表明传导系统细胞比收缩细胞对缺氧更具抵抗力。室性心律失常通常与有利于折返的传导阻滞同时出现。当阻滞更明显时,心律失常更频繁。我们的数据表明,在某些情况下,传导障碍先于RS-T段正向移位出现,而在另一些情况下,它掩盖了这种移位。得出的结论是,RS-T段移位、远端传导阻滞和心律失常是急性心肌缺血诱导的部分舒张期去极化在不同水平的表现。

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