Alcohol ablation at the posterior papillary muscle prevents ventricular fibrillation in swine without affecting mitral valve function.
Alcohol ablation at the posterior papillary muscle prevents ventricular fibrillation in swine without affecting mitral valve function.
复制标题
后乳头肌的酒精消融可预防猪的心室颤动，而不影响二尖瓣功能。
DOI：
10.1093/europace/euq337
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
Yang,Xin-Chun
中科院分区：
文献类型：
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作者：
Guo,Lei-Sheng;Zhou,Xu;Li,Yan-Hui;Cai,Jun;Wei,Dong-Mei;Shi,Liang;Yang,Gang;Armoundas,AntonisA;Yang,Xin-Chun
目的射频消融后乳头肌(PM)可显著降低兔和犬室颤(VF)的诱发率，提示PM可能参与了VF的发生。然而，在正常完整的猪心中，在PM处消融对VF诱发率的影响尚不清楚，因为在这种物种中，在PM处发出的射频能量会引起不间断的VF。方法和结果12只麻醉猪行正中胸骨切开。在超声引导下，将无水酒精注入左心室后膜(PM组，n=6)或前壁底部(对照组，n=6)进行化学消融。消融前、后分别测定室颤诱发率和二尖瓣功能。移植心脏，消融心肌苏木精-伊红染色。PM组的室颤诱发率从消融前的100±0%降至消融后的11.9±7.8%(P=0.001)，而对照组消融前与消融后比较差异无统计学意义(100±0vs.92.9±7.1%)。消融心肌中央可见出血和细胞坏死，后PM消融后未见明显二尖瓣返流。结论乙醇消融左后PM可降低正常猪心VF诱发率，但不存在明显的二尖瓣返流。提示后PM可能参与了室颤的发生，化学消融后PM可预防VF的复发
AimsRadiofrequency ablation at the posterior papillary muscle (PM) significantly reduced ventricular fibrillation (VF) inducibility in rabbits and dogs, suggesting that PM may be involved in the generation of VF. However, the effect of ablation at the PM on VF inducibility remains unknown in normal intact swine hearts because in this species radiofrequency energy delivered at PM provoked incessant VF.Methods and resultsTwelve anesthetized swine underwent median sternotomy. Under the ultrasonographic guidance, chemical ablation was performed via injection of dehydrated alcohol into the base of the posterior PM (group PM,n= 6) or anterior wall (control group,n= 6) in the left ventricle. Ventricular fibrillation inducibility and mitral valve function were measured pre- and post-ablation. Hearts were explanted and the ablated myocardium was stained with haematoxylin and eosin. Ventricular fibrillation inducibility was significantly decreased from 100 ± 0% pre-ablation to 11.9 ± 7.8% post-ablation in group PM (P= 0.001), whereas it was not statistically different in the control group (100 ± 0 vs. 92.9 ± 7.1%, pre-ablation vs. post-ablation). Haemorrhage and cellular necrosis was observed in the centre of ablated myocardium and no significant mitral regurgitation was observed following ablation at the posterior PM.ConclusionAlcohol ablation of the left posterior PM reduced VF inducibility in normal intact swine hearts, with no significant mitral regurgitation. This suggests that the posterior PM may be involved in the generation of VF, and the recurrence of VF may be prevented by chemical ablation at the posterior PM.