REGIONAL CONTROL OF ATRIAL-FIBRILLATION BY RAPID PACING IN CONSCIOUS DOGS
REGIONAL CONTROL OF ATRIAL-FIBRILLATION BY RAPID PACING IN CONSCIOUS DOGS
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DOI：
10.1161/01.cir.84.4.1689
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发表时间：
1991-10-01
期刊：
影响因子：
37.8
通讯作者：
BRUGADA, J
中科院分区：
文献类型：
--
作者：
ALLESSIE, M;KIRCHHOF, C;BRUGADA, J
背景。在5个长期仪器有意识的狗，我们研究了快速起搏对持续电诱发心房颤动的影响。方法与结果。同时记录左、右心房外侧壁和巴赫曼束23张单极心房电图。在持续性房颤期间，表面心电图显示基线持续不规则，无P波或F波，心室节律不规则，QRS复合物狭窄。心房电图显示快速不规则活动，中位周期长度为85 +/- 8 msec，范围（P5-95）为33 +/- 18 msec。采用对称双相矩形刺激（持续时间2毫秒，阈值的6倍）对左心房附件的一对刺激电极进行心房颤动的超速起搏。刺激开始时的起搏间隔比局部中位颤动间隔长约10毫秒，随后每隔1毫秒缩短一次。在略短于中位纤颤间隔的临界起搏间隔时，起搏部位周围的心房突然被电刺激捕获。局部捕获区直径为6.1±1.6 cm。捕获时间窗为12±4毫秒。这些观察结果表明，在长期使用仪器的有意识狗的电诱发心房颤动期间，存在一个短的可兴奋间隙，允许通过快速起搏来局部控制颤动过程。
Background. In five chronically instrumented conscious dogs, we studied the effects of rapid pacing on sustained electrically induced atrial fibrillation.Methods and Results. Twenty-three unipolar atrial electrograms were recorded simultaneously from the bundle of Bachmann and the lateral wall of the right and left atria. During sustained atrial fibrillation, the surface electrocardiogram showed continuous irregularities of the baseline without P or F waves as well as an irregular ventricular rhythm with narrow QRS complexes. The atrial electrograms showed rapid irregular activity with a median cycle length of 85 +/- 8 msec and a range (P5-95) of 33 +/- 18 msec. Overdrive pacing of atrial fibrillation was performed using symmetric biphasic rectangular stimuli (2-msec duration, sixfold that of threshold) applied to a pair of stimulating electrodes at the left atrial appendage. Stimulation was started at pacing intervals of about 10 msec longer than the local median fibrillation interval and subsequently shortened in steps of 1 msec. At a critical pacing interval slightly shorter than the median fibrillation interval, the atrium around the pacing site was suddenly captured by the electrical stimuli. The area of local capture had a diameter of 6.1 +/- 1.6 cm. The time window of capture was 12 +/- 4 msec.Conclusions. These observations show that during electrically induced atrial fibrillation in chronically instrumented conscious dogs, a short excitable gap is present, permitting regional control of the fibrillatory process by rapid pacing.