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目的:测定心房不同部位的有效不应期(ERP),并探讨其与心房颤动(AF)发生的相互关系。方法:山羊15只,运用程序刺激(S1S2程序刺激,基础起搏周长(PCL)分别为400ms、350ms、300ms、250ms、200ms;S2为200ms,以5ms的步长递减)测定正常左心耳、右心耳、左上肺静脉口、左下肺静脉口、右上肺静脉口及右下肺静脉口的ERP。程序刺激结合Burst刺激对上述心房部位进行AF诱发,记录AF的发生率。结果:左心耳、左上肺静脉口、左下肺静脉口、右上肺静脉口及右下肺静脉口的ERP差异无统计学意义(P>0.05);上述部位的ERP较右心耳ERP短(P<0.05),AF发生率较右心耳高(P<0.05)。结论:左心房及肺静脉固有的电生理特点可能是AF主要来源于左心房的一个重要因素。
OBJECTIVE: To determine the effective refractory period (ERP) in different parts of the atrium and to explore its relationship with the occurrence of atrial fibrillation (AF). Methods: Fifteen goats were used to determine the normal left atrial appendage by program stimulation (S1S2 program stimulation, basal pacing circumference (PCL) of 400 ms, 350 ms, 300 ms, 250 ms, 200 ms, S2 of 200 ms, Right atrial appendage, left upper pulmonary vein ostium, left lower pulmonary veins, right upper pulmonary vein and right lower pulmonary veins. Procedural stimulation combined with Burst stimulation AF-induced atrial fibrillation, recording the incidence of AF. Results: There was no significant difference in ERP between left atrial appendage, left superior pulmonary vein, left inferior pulmonary vein, right superior pulmonary vein and right inferior pulmonary vein (P> 0.05) The incidence was higher than the right ear (P <0.05). Conclusion: The intrinsic electrophysiological characteristics of the left atrium and pulmonary veins may be an important factor of AF mainly from the left atrium.