Marshall韧带消融对心肌不应期和心肌梗死后室性心律失常的影响.pdf

·i仑善·JMedRes，Nov2016，Vo1．45No．11

Marshall韧带消融对心肌不应期和

心肌梗死后室性心律失常的影响

何文博余小梅鲁志兵何勃谢菁王松云黄兵江洪

摘要目的研究Marshall韧带消融对心肌有效不应期和室性心律失常的影响。方法21只杂种犬随机分为Marshall韧

带消融组(n=11)和对照组(n=10)。记录左、右心房和左、右心室不同部位的电图，并测量各部位有效不应期(effectiverefractory

period，ERP)，计算ERP的空间离散度。消融组实验犬采用大头电极对Marshall韧带进行消融，消融后再次测量ERP，计算ERP

离散度。对照组犬不行消融。测量结束后，结扎冠状动脉左前降支，持续体表心电图记录1h，记录室性心律失常发生情况。结果

与基础状态相比，Marshall韧带消融后左、右心室和右心房的ERP显著延长，左心房的ERP变化不显著，心房和心室的ERP离散

度在消融前后无显著差异。结扎冠脉左前降支后，消融组的室性期前收缩数和室性心动过速阵数显著低于对照组，消融组的心

室颤动和室性心动过速发生率与对照组差异无统计学意义(P0．05)。结论Marshall韧带消融可延长犬左、右心室和右心房

的ERP，而对ERP离散度无显著影响。Marshall韧带消融对心肌梗死后室性心律失常的发生可能有保护作用。

关键词Marshall韧带室性心律失常有效不应期

中图分类号R541．7文献标识码AD0I10．11969／i．issn．1673—548X．2016．11．008

EffectsofMarshallLigamentAblationonMyocardialRefractoryPeriodandPost—infarctionVentricularArrhythmias．HeWenbo，YuXi-

aomei，LuZhibing，eta1．DepartmentofCardiology，RenminHospitalofWuhanUniversity，Hubei430060，China

AbstractObjectiveToinvestigatetheeffectofMarshallligamentablationonmyocardialeffectiverefractoryperiodandventricular

arrhythmogenesis．MethodsTwenty—onemongreldogswererandomlydividedintoablationgroup(n=11)andcontrolgroup(n=

10)．Electrogramswererecordedatdifferentsitesonbothventriclesandatria．Effectiverefractoryperiod(ERP)wasmeasuredandthe

spatialdispersionofERPwascalculatedbeforeandafterablationofligamentofMarshal1．Inthecontrolgroupablationwasnotperformed．

ThentheleftanteriordescendingcoronaryarterywasligatedandsurfaceECGwascontinuouslyrecordedfor1hourtoobservetheoccur—

renceofventrieulararrhythmias．ResultsComparedwithbaseline，ERPsofrightatrium，leftventricleandrightventriclewereallin-

creasedafterablationofligamentofMarshall，whileERPofleftatriumwasnotchangedsignificantly．ThedispersionofERPwasnot

changedbeforeandafterablation．Afterligationofleft