Epicardial excitation during ventricular pacing. Relative independence of breakthrough sites from excitation sequence in canine right ventricle.
Epicardial excitation during ventricular pacing. Relative independence of breakthrough sites from excitation sequence in canine right ventricle.
复制标题
心室起搏期间心外膜兴奋。
DOI：
10.1161/01.res.71.4.840
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发表时间：
1992
影响因子：
20.1
通讯作者：
Taccardi,B
中科院分区：
文献类型：
--
作者：
Arisi,G;Macchi,E;Corradi,C;Lux,RL;Taccardi,B
在之前的研究中，使用1，124个紧密间隔的电极进行的心外膜记录显示，在正常窦性心律期间，暴露的犬心脏的心室表面上有20-35个突破（BKT）部位和相同数量的单独波前。在本研究中，我们试图1）确定心室起搏是否也产生多个BKT和波前，2）确定BKT的数量和位置在某种程度上是否与起搏部位无关。该研究主要关注在右心室起搏期间观察到的右心室BKT。为了检验假设1和2，我们在7只暴露的犬心脏中确定了窦性心律期间的许多突破部位，然后从右心室的几个BKT和非BKT部位起搏心脏。通过使用覆盖右心室前部和部分左心室前部的1，124个心外膜电极获得心外膜电位图和兴奋时间图。主波阵面从起搏部位放射状扩展数厘米，在主波阵面覆盖的区域内未出现BKT。在其余区域（次级区域），出现多个BKT;其数量接近于在相同区域窦性心律期间观察到的数量（12次起搏搏动中分别为113次和115次）。大多数起搏BKT（83/115，或72%）发生在窦性心律期间出现的相同位置。然而，在窦性心律期间观察到的30例右心室BKT在次级区域消失，并被大约相同数量的新BKT取代。在正常搏动中没有BKT的许多区域在起搏搏动中仍然如此。（250字处删节）
In a previous investigation, epicardial recordings with 1,124 closely spaced electrodes revealed 20-35 breakthrough (BKT) sites and an equal number of separate wave fronts on the ventricular surface of exposed dog hearts during normal sinus rhythm. In the present study we tried 1) to determine whether ventricular pacing also produced multiple BKTs and wave fronts and 2) to determine whether the number and location of BKTs were, to some degree, independent of pacing site. The study mainly focused on right ventricular BKTs observed during right ventricular pacing. To test hypotheses 1 and 2 we identified many breakthrough sites during sinus rhythm in seven exposed dog hearts and then paced the heart from several BKT and non-BKT sites on the right ventricle. Epicardial potential maps and excitation time maps were obtained by using 1,124 epicardial electrodes covering the anterior right ventricle and part of the anterior left ventricle. A primary wave front spread radially for several centimeters from the pacing site, and no BKTs appeared in the areas covered by the primary wave front. In the remaining areas (secondary areas), multiple BKTs appeared; their number was close to that observed during sinus rhythm in the same areas (113 versus 115, respectively, in 12 paced beats). The majority of paced BKTs (83 out of 115, or 72%) occurred exactly at the same locations where they appeared during sinus rhythm. However, 30 right ventricular BKTs observed during sinus rhythm disappeared in the secondary areas and were replaced by approximately the same number of new BKTs. Many areas without BKTs in normal beats remained so in paced beats.(ABSTRACT TRUNCATED AT 250 WORDS)