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目的心房电重构可导致心房有效不应期缩短,通过测量心房有效不应期来研究迷走神经对心房电重构的影响。方法 10只成年犬给予酒石酸美托洛尔和阿托品阻断交感神经和迷走神经。分别测量心房电重构前后基础状态及迷走神经刺激下的心房有效不应期(ERP)和房颤易感窗口(VW)。结果①阿托品应用前后基础状态下的ERP无变化。阿托品应用前后迷走神经刺激下的ERP变化明显;②心房电重构后ERP:基础状态及迷走神经刺激下,无论右心房还是冠状静脉窦远端测得的ERP与重构前(阿托品应用后)ERP相比无明显差异(p值均>0.05);③VW的变化:阿托品应用前,迷走神经刺激下容易诱发房颤。阿托品应用后,心房电重构前后无论基础状态或迷走神经刺激均不能诱发房颤。结论迷走神经阻滞能减轻心房电重构所导致的心房不应期缩短,从而抑制迷走神经介导的房颤诱发。
The purpose of atrial electrical remodeling can lead to shortening of the effective refractory period of the atrium, to study the effect of the vagus nerve on atrial electrical remodeling by measuring the effective refractory period of the atrium. Methods Ten adult dogs were treated with metoprolol tartrate and atropine to block the sympathetic and vagal nerves. Atrial electrical remodeling before and after basal state and vagal stimulation of atrial effective refractory period (ERP) and atrial fibrillation susceptibility window (VW) were measured. Results ① There was no change of ERP in basal state before and after atropine application. Atrial natriuretic peptide (ERP) after vagal nerve stimulation before and after atropine application; (2) ERP after atrial electrical remodeling: basal state and vagus nerve stimulation, no matter whether ERP of the right atrium or the coronary sinus distal to the remodeling (after atropine application) ERP phase (P> 0.05); ③ VW changes: atropine application before vagus nerve stimulation is likely to induce atrial fibrillation. Atropine application, atrial electrical remodeling before or after the basal state or vagus nerve stimulation can not induce atrial fibrillation. Conclusion Vagus nerve block can reduce atrial electrical remodeling caused by shortening of atrial refractory period, thus inhibiting vagal-mediated atrial fibrillation induced.