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中华临床医师杂志(电子版) ›› 2021, Vol. 15 ›› Issue (05) : 370 -374. doi: 10.3877/cma.j.issn.1674-0785.2021.05.011

基础研究

心脏神经结丛消融联合低强度耳屏迷走神经刺激对犬房颤电生理特性的影响
杨志1, 张峰2, 雷芾华2, 程文波3, 侯月梅3,()   
  1. 1. 831199 新疆昌吉,新疆医科大学第一附属医院昌吉分院心血管内科
    2. 201508 上海,复旦大学附属金山医院心内科
    3. 201400 上海,上海交通大学附属第六人民医院南院老年科
  • 收稿日期:2021-01-09 出版日期:2021-05-15
  • 通信作者: 侯月梅
  • 基金资助:
    国家自然科学基金(81670308); 上海市科委创新行动计划(20Y11909900)

Effects of cardiac plexus ablation combined with low intensity tragus vagus nerve stimulation on electrophysiological characteristics of atrial fibrillation in dogs

Zhi Yang1, Feng Zhang2, Fuhua Lei2, Wenbo Chen3, Yuemei Hou3,()   

  1. 1. Department of Cardiology, Changji Branch of the First Affiliated Hospital of Xinjiang Medical University, Changji 831199, China
    2. Department of Cardiology,Jinshan Hospital of Fudan University, Shanghai 201508, China
    3. Department of Geriatrics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Camplus, Shanghai 201400, China
  • Received:2021-01-09 Published:2021-05-15
  • Corresponding author: Yuemei Hou
引用本文:

杨志, 张峰, 雷芾华, 程文波, 侯月梅. 心脏神经结丛消融联合低强度耳屏迷走神经刺激对犬房颤电生理特性的影响[J/OL]. 中华临床医师杂志(电子版), 2021, 15(05): 370-374.

Zhi Yang, Feng Zhang, Fuhua Lei, Wenbo Chen, Yuemei Hou. Effects of cardiac plexus ablation combined with low intensity tragus vagus nerve stimulation on electrophysiological characteristics of atrial fibrillation in dogs[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2021, 15(05): 370-374.

目的

研究心脏神经节丛消融联合低强度耳屏迷走神经刺激对阵发性犬心房颤动(简称房颤)电生理特性的影响,探讨低强度耳屏迷走神经刺激对房颤消融术后的治疗价值。

方法

21条健康成年比格犬随机分为3组:RAP组(500次/min快速心房起搏,n=7)、ABL组(心脏神经节消融+500次/min快速心房起搏,n=7)、LL-ST组(心脏神经节消融+低强度右侧耳屏刺激+500次/min快速心房起搏,n=7)。其中,RAP组为单纯快速心房起搏,ABL组为右上神经节丛(ARGP)和左上神经节丛(LSGP)消融后快速心房起搏,LL-ST组为ARGP+LSGP消融后低强度刺激右侧耳屏迷走神经+快速心房起搏。于起搏前及起搏后2、4、6、8、10、12、14、16 h测定犬心房和肺静脉不同部位的房颤诱发率、房颤持续时间、有效不应期(ERP)及有效不应期离散度(dERP)。

结果

(1)与RAP组相比,LL-ST组房颤诱发率显著降低,房颤持续时间显著减少,ERP显著延长,dERP显著降低,差异有统计学意义(P均<0.05)。(2)与ABL组相比,LL-ST组房颤诱发率显著降低,房颤持续时间显著减少,ERP显著延长,dERP显著降低,差异均有统计学意义(P<0.05)。

结论

低强度右侧耳屏迷走神经刺激联合心脏神经节丛消融可以有效控制房颤消融术后的复发。

Objective

To study the effect of cardiac ganglion plexus ablation combined with low intensity tragus vagus nerve stimulation on electrophysiological characteristics in a dog model of atrial fibrillation, and to explore the value of tragus vagus nerve stimulation in preventing the recurrence of atrial fibrillation after ablation.

Methods

Twenty-one adult beagle dogs were randomly divided into three groups: RAP group (n=7; 500 times/min rapid atrial pacing), ABL group [n=7; ablation of the right superior ganglion plexus (ARGP) and left superior ganglion plexus (LSGP) + 500 times/min rapid atrial pacing], and LL-ST group (n=7; ARGP and LSGP ablation + low intensity right ear vagus nerve stimulation + 500 times/min rapid atrial pacing). At baseline and 2, 4, 6, 8, 10, 12, 14, and 16 h after pace-making, the inducibility and duration of atrial fibrillation, effective refractory period (ERP), and dispersion effective refractory period(dERP) in different locations of the atrium and pulmonary veins were detected.

Results

(1) Compared with RAP group, the inducibility and duration of atrial fibrillation were significantly reduced in the LL-ST group (P<0.05); the ERP was significantly prolonged and the dERP was significantly decreased (P<0.05). (2) Compared with ABL group, the inducibility and duration of atrial fibrillation were significantly reduced in the LL-ST group (P<0.05); the ERP was significantly prolonged and the dERP was significantly decreased (P<0.05).

Conclusion

Low intensity right tragus stimulation combined with cardiac ganglion plexus ablation can effectively control the recurrence of atrial fibrillation after ablation.

图1 各组不同刺激时间对LA、LIPV、LSPV部位AF诱发率的影响(n=7)。图a为各组LA在不同刺激时间的AF诱发率;图b为各组LIPV在不同刺激时间的AF诱发率;图c为各组LSPV在不同刺激时间的AF诱发率
图2 各组不同刺激时间对LA、LIPV、LSPV部位AF持续时间的影响(n=7)。图a为各组LA在不同刺激时间的AF持续时间;图b为各组LIPV在不同刺激时间的AF持续时间;图c为各组LSPV在不同刺激时间的AF持续时间
图3 各组不同刺激时间对LA、LIPV、LSPV部位ERP及dERP的影响(n=7)。图a为各组LA在不同刺激时间的ERP;图b为各组LSPV在不同刺激时间的ERP;图c为各组LIPV在不同刺激时间的ERP;图d为各组在不同刺激时间的dERP
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