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为探讨持续心房颤动 (AF)肺静脉有效不应期 (ERP)变化的时间进程及其逆转 ,运用起搏方法建立AF模型 ,在起搏前和起搏后的第 1 ,2 ,3,4 ,5 ,6 ,7d对左上肺静脉口、左下肺静脉口、右上肺静脉口及右下肺静脉口的ERP进行测定。采用S1 S2 程序刺激 ,基础起搏周长 (S1 S1 )分别为 4 0 0 ,35 0 ,30 0 ,2 5 0 ,2 0 0ms,S2 为 2 0 0ms,以 5ms的步长递减。程序刺激结合猝发刺激对上述心房结构进行AF的诱发 ,记录AF的发生频率。上述相同方法对起搏停止后 1 ,2 ,3,4 ,5 ,6 ,2 4h 4个肺静脉口的ERP进行测定。结果 :各个基础起搏周长下 4个肺静脉口的ERP在AF后 1 ,2 ,3,4 ,5 ,6 ,7d逐渐缩短 ,且较AF前明显缩短 ,P <0 .0 5 ;AF终止后 4个肺静脉口的ERP逐渐延长 ,但AF终止后 0 ,1 ,2 ,3,4 ,5 ,6hERP与AF前相比仍有明显缩短 ,P <0 .0 5 ;AF终止后 2 4hERP基本恢复到AF前水平 ,随着AF持续时间的延长 4个肺静脉口AF的诱发率逐渐增高 ,与AF前相比 ,AF后 1 ,2 ,3,4 ,5 ,6 ,7dAF的诱发率明显增高 ,P <0 .0 5。结论 :随着AF持续 ,肺静脉的ERP逐渐缩短 ,AF的诱发率逐渐增高 ,AF终止后缩短的ERP逐渐延长致AF前水平。
In order to investigate persistent atrial fibrillation (AF) pulmonary vein effective refractory period of time to reverse course and change (ERP), using the pacing method to establish AF model, after pacing and pacing in front of 1, 2, 3, 4, The left upper pulmonary vein ostium, the left lower pulmonary vein ostium, the right upper pulmonary vein ostium and the right lower pulmonary vein ostium were measured at 5, 6 and 7 days. Stimulation with S1 S2 program, basal pacing circumference (S1 S1) were 4 0 0, 35 0, 30 0, 25 0, 20 ms, S2 was 20 ms, decreasing in steps of 5 ms. Program stimulation combined with burst stimulation of the atrial structure induced by AF, recording the frequency of occurrence of AF. The same method described above was used to determine the ERP of 4 pulmonary vein ports 1, 2, 3, 4, 5, 6, 24 h after pacing stopped. Results: The ERPs of the four pulmonary veins at each basal pacing circumference gradually shortened at 1, 2, 3, 4, 5, 6 and 7 days after AF, and were significantly shorter than before AF (P <0.05) after 4 ostium ERP gradually extended, but the termination of AF 0, 1, 2, 3, 4, 5, the front 6hERP still significantly reduced compared with AF, P <0 .0 5; 2 4hERP substantially after the termination of AF AF restored to the level before, with the extension of the duration of the lung vein ostium. 4 AF AF induced increased gradually, compared with the previous AF, the AF 1, 2, 3,4, 5, 6, induced significantly higher rate 7dAF , P <0. 0 5. CONCLUSION: As AF persists, the ERP of pulmonary veins gradually decreases and the induction rate of AF gradually increases. The shortened ERP gradually extends to the pre-AF level after AF termination.