Mapping of ventricular tachycardia induced by programmed stimulation in canine preparations of myocardial infarction.
Mapping of ventricular tachycardia induced by programmed stimulation in canine preparations of myocardial infarction.
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在犬心肌梗塞制剂中通过程序刺激诱导的室性心动过速的绘图。
DOI：
10.1161/01.cir.70.1.136
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发表时间：
1984
期刊：
影响因子：
37.8
通讯作者：
P. Pagé
中科院分区：
文献类型：
--
作者：
R. Cardinal;P. Savard;D. L. Carson;J. Perry;P. Pagé
为探讨程序刺激诱发均匀性室性心动过速的机制，我们记录了64个心外膜下、心内膜下和室壁内部位的希氏束电图和单极电图。等时线图由计算机离线生成。两组狗进行了研究3天后，他们的左冠状动脉前降支闭塞;一组进行再灌注后2至2.5小时的闭塞和其他甲基强的松龙治疗永久闭塞之前。在前者，subepicardial序列提出了一种模式，表明马戏团运动或放射状模式，在壁内部位的兴奋可能先于最早的subepicardial兴奋。在后者的准备工作中，心外膜下的兴奋模式始终表明马戏团运动的心外膜下的肌肉层生存的坏死组织。假设完整的马戏团运动，“错过”的时间间隔，测量的间隔左室性心动过速周期之间的局部兴奋的实际记录，从3%到64%的室性心动过速周期长度。虽然存活的心外膜下和壁内层似乎参与了室性心动过速的机制，但右心室的第二次突破，以及希氏束电图上的固定耦合H偏转，表明传导系统参与了脉冲的传播。
To investigate the mechanism of uniform ventricular tachycardia induced by programmed stimulation, we recorded His bundle electrograms and unipolar electrograms from 64 subepicardial, subendocardial, and intramural sites in dogs. Isochronal maps were generated off-line by computer. Two groups of dogs were studied 3 days after occlusion of their left anterior descending coronary arteries; one group underwent reperfusion after 2 to 2.5 hr of occlusion and the other methylprednisolone treatment before permanent occlusion. In the former, subepicardial sequences presented either a pattern suggesting circus movement or a radial pattern in which excitation at intramural sites could precede earliest subepicardial excitation. In the latter preparations, subepicardial excitation patterns consistently suggested circus movement in the subepicardial muscle layer surviving over necrotic tissue. Assuming complete circus movement, the "missed" time interval, measured as the interval left unaccounted for by actual recording of local excitation between ventricular tachycardia cycles, ranged from 3% to 64% of the cycle length of ventricular tachycardia. While surviving subepicardial and intramural layers appeared to be involved in the mechanism of ventricular tachycardia, a late second breakthrough on the right ventricle, in conjunction with fixed-coupled H deflections on the His bundle electrograms, suggested the involvement of the conducting system in propagation of the impulse.