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应用心内膜接触电极导管,记录犬缺血-再灌注时在体心脏左室单相动作电位(MAP),观察急性心肌缺血对 MAP 的影响及其与心律失常、心电图改变的关系。15只犬,共行缺血(20min)-再灌注实验24次.缺血时 MAP 振幅(MAPA)由对照的28±4mV 降至17±4mV(P<0.001),MAP 平台相由对照的134±15ms 缩短至112±14ms(P<0.001),于再灌注1min 内恢复至对照水平.缺血性心律失常的发生有2个高峰期,分别发生于冠状动脉结扎1～7min 及14～19min.其发生前均有 MAPA、MAP 平台相或 MAP3相的交替变化,伴有缺血区左心腔电图 ST—T 电交替.结果表明:MAPA 降低、MAP 平台相缩短是局部心肌缺血的特异性电生理学改变;MAP 和 ST—T 电交替现象反应了心电活动紊乱及复极非均质性,是发生严重心律失常的预兆。
The application of endocardial catheter in contact with the catheter to record the single-phase left ventricular action potential (MAP) during ischaemia-reperfusion in canine and to observe the effect of acute myocardial ischemia on MAP and its relationship with arrhythmia and electrocardiogram changes. Fifteen dogs were randomly divided into two groups: ischemia (20min) and reperfusion (24th), the MAP amplitude decreased from 28 ± 4mV to 17 ± 4mV (P <0.001) ± 15ms to 112 ± 14ms (P <0.001), and recovered to the control level within 1min after reperfusion.The occurrence of ischemic arrhythmia had two peaks at 1 ~ 7min and 14 ~ 19min after ligation of coronary artery respectively. Both of them had alternation of MAPA, MAP or MAP3 phase, accompanied by ST-T electrocardiogram alternation in ischemic area.The results showed that the decrease of MAPA and the shortening of MAP phase were characteristic of local myocardial ischemia Sex electrophysiological changes; MAP and ST-T alternating phenomenon reflects the ECG disturbance and bipolar heterogeneity, is a sign of serious arrhythmia.