Arrhythmogenic difference between the left and right atria during rapid atrial activation in a canine model of atrial fibrillation
Arrhythmogenic difference between the left and right atria during rapid atrial activation in a canine model of atrial fibrillation
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DOI：
10.1253/circj.71.1629
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发表时间：
2007-10-01
影响因子：
3.3
通讯作者：
Izumi, Tohru
中科院分区：
文献类型：
--
作者：
Niwano, Shinichi;Kojima, Jisho;Izumi, Tohru
研究背景持续快速心房刺激可引起心房重构，但左心房（LA）和右心房（RA）的致心律失常性差异尚不清楚。方法和结果14只Beagle犬，分别从右心耳（RAA）和左心耳（LAA）连续快速起搏（400次/min）2周。从4个心房部位：（1）RAA，（2）下腔静脉附近（IVC），（3）Bachmann束（BB）和（4）LA，观察心房有效不应期（ERP）、ERP离散度和心房颤动（AF）的诱发。ERP表现出进行性缩短在所有的网站，但缩短的程度不同。在RA刺激组中，RAA和LA的ERP缩短比IVC或BB更显著。相反，在LA刺激组中，ERP缩短在LA比在其他部位更突出。结果表明，刺激左心房组ERP离散度大于刺激右心房组，刺激左心房组AF诱发率高于刺激右心房组，尤以左心房部位为甚（p < 0.05）。这一结果可能部分解释了在房颤临床病例中肺静脉发生的过早收缩的重要性。
Background Continuous rapid atrial stimulation causes atria] remodeling, but little is known about the difference in the arrhythmogenicity of the left (LA) and right atria (RA).Methods and Results In 14 beagle dogs, continuous rapid pacing (400beats/min) was delivered from the right (n=7) or left (n=7) atrial appendage (RAA or LAA) for 2 weeks. The atrial effective refractory period (ERP), ERP dispersion, and inducibility of atrial fibrillation (AF) were evaluated along the time course from 4 atrial sites: (1) RAA, (2) area close to the inferior vena cava (IVC), (3) Bachmann's bundle (BB) and (4) LA. The ERP exhibited progressive shortening at all sites, but the degree of shortening differed among them. In the RA stimulation group, ERP shortening was more prominent in the RAA and LA than in the IVC or BB. In contrast, in the LA stimulation group, ERP shortening was more prominent in the LA than in the other sites. As a result, ERP dispersion was larger in the LA stimulation group than in the RA stimulation group and the AF inducibility was higher in the LA stimulation group than in the RA stimulation group, especially at the LA site (p < 0.05).Conclusion LAA stimulation was more arrhythmogenic than RAA stimulation in this model. This result may partly explain the importance of premature contractions occurring from the pulmonary veins in clinical cases of AF.