体外冲击波对心脏电生理的影响(1)
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【摘要】目的:探讨体外冲击波(ESW)对犬心脏电生理的影响及其诱发心律失常的特点和机理。方法:以杂种犬的右心房、房室交界区、右室心尖部作为ESW的靶点,分别测定ESW冲击犬心脏各靶点前、后心脏电生理参数,并记录ESW冲击犬心脏前、后各4小时及冲击心脏过程中心律失常的类型及其数量。结果:ESW冲击犬心脏各靶点后,窦房结恢复时间及校正窦房结恢复时间明显延长(P<0.05),心肌有效不应期、舒张期阈值等参数无明显变化(P>0.05);ESW诱发早搏的特点:(1)来源于靶点区的早搏明显多于非靶点区的早搏;(2)ESW冲击心脏过程中前半程的早搏明显多于后半程的早搏;(3)落在体表心电图T-P段的ESW易诱发室性早搏,而落在T波降支的ESW则易诱发房性早搏或交界性早搏。结论:早搏由ESW直接诱发,并有适应现象;早搏的机制可能与ESW导致心肌牵张有关。
【关键词】体外冲击波;心律失常;窦房结恢复时间;有效不应期;阈值
doi:10.3969/j.issn.1006-1959.2010.08.110文章编号:1006-1959(2010)-08-2089-03
Effects of extracorporeal shock wave on canine cardioelectrophsiology Study of effects of ESW on canine hemodynamicZHANG Xiao-yong,XU Wei-ping,QIU Han-ying
1.Department of cardiology,Qingyuan peoples Municipal Hospital,Qingyuan 511500;2.Department of cardiology,The Second Affiliated Hospital,medical college,Shantou University 515041
【Abstract】Objective:To study effects of extracorporeal shock wave(ESW) on canine cardioelectrophysiology and to study mechanisms and characteristics of arrhythmia induced by ESW.Materials:ESW were discharged respectively at the right atrium,atrioventricle junction area and apex of the right ventricle.cardioelectrophsiological parameters were determined after and before discharges of ESW,Categories and their counts of arrhythmias were recorded for 1 hours before and after discharges of ESW and in the course of discharges of ESW.Results:After discharges of ESW,sinoatrial node recovery time (SNRT) and corrected sinoatrial node recovery time (SNRTc) were obviously delayed(P<0.05).Effective refractory period (ERP),diastolic threshold of atrium and ventricle and other parameters remained unchanged (P>0.05).There were following characters in premature beats induced by ESW in the course of discharges:There were more premature beats originated from the targets of ESW than that from the non-target.There were more premature beats during the first half procedure than the second.when discharges of ESW on the T-P segment of ECG,ventricular premature beats were induced easy;atrial and atrioventriclar premature beats were easy induced when discharges of ESW on descent phase of T wave ......
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