Effectiveness and safety of intrauterine pacing for fetal arrhythmia (comple atrioventricular block) - an experimental study

1992年，我们对胎羔宫内经静脉心脏起搏进行了研究。起搏电极通过颈内静脉和三尖瓣向前推进。起搏器起搏速度为200次/分。起搏时右室输出量由107ml/kg/min降至78ml/kg/min。虽然当起搏速度为200次/分钟时，右室输出量减少，但当出现完全性心脏传导阻滞和充血性心力衰竭时，这种方法可能有用。1993年，我们研究了胎羊宫内急性心房起搏。起搏电极经右胸切开缝合于右心房。右心房的起搏速度分别为200、300、350和400次/分钟。当起搏速度超过200次/分时，右室输出量减少。在1994年，我们研究了胎羊宫内慢性心房起搏，利用这个房性心动过速模型，我们可以估计胎儿的血液循环。在这项初步研究中，观察到当慢性起搏速度为300次/分钟时胎儿积水。

In 1992, we have investigated intrauterine transvenous ventricular pacing in fetal lamb. The pacing lead was advanced through the internal jugular vein and the tricuspid valve. The fetal right ventricle was paced by a pacemaker at a rate of 200/min. The right ventricular output decreased from 107 ml/kg/min to 78 ml/kg/min while paced. Although the right ventricular output decreased when paced at 200/min, this method might be useful when there is a complete heart block and congestive heart failure.In 1993, we have investigated intrauterine acute atrial pacing in fetal lamb. The pacing lead was sutured on the right atrium through the right thoracotomy. The right atrium was paced at 200,300,350, and 400/min. The right ventricular output decreased when paced at more than 200/min. Using this atrial tachy arrhythmia model, we can estimate the human fetal circulation with tachy arrhythmia.In 1994, we have investigated intrauterine chronic atrial pacing in fetal lamb. In this preliminary study, the fetal hydrops was observed when chronically paced at 300/min.