摘要目的 探讨系统消融犬心外膜脂肪垫(完全去迷走神经)的远期心电生理效应.方法 成年雄性杂种犬16条,随机分为消融组和假手术组(各8条).消融组犬经开胸途径消融心外膜所有可视脂肪垫,假手术组仅进行开胸手术.术后8周行心内电生理检查,测定右心房、左心房、左心室、右心室心尖部及右心室流出道等部位的不应期,并进行房性及室性快速心律失常的诱发.结果 术后8周实验组基础心率( 163.8±12.2)次/min显著高于假手术组对(122.7±13.0)次/min( P＜0.001)；消融组犬的右心房、左心房、左心室、右心室心尖部及右心室流出道不应期分别较假手术组显著缩短(除右心室心尖部P=0.012外,其他部位P＜0.001),同时该组的快速房性心律失常诱发率显著增加(P=0.04),两组间的室性快速心律失常诱发率差异无统计学意义.结论 仅消融犬心外膜脂肪垫可能具有远期致心律失常作用,尤其在心房水平.

abstractsObjective To investigate the long-term electrophysiological effects of systemic atrial epicardial fat pad ablation (to achieve complete vagal denervation).Methods Sixteen male mongrel adult dogs were randomly divided into the experimental group (n =8 ) and the sham-operation group (n =8 ).In experimental group,the dogs underwent ablation for all visible atrial epicardial fat pad until complete vagal denervation was achieved,while the dogs in the sham-operation group underwent thoracotomy only.After 8 weeks,the electrophysiological study was performed to measure the effective refractory period (ERP) of atrium and yentrides,and induce atrial tachycardia and ventricular tachycardia.Results The baseline heart rate of experimental group was higher than that in the sham-operation group 8 weeks after the procedure [ ( 163.8±12.2)bpm vs ( 122.7±13.0) bpm,P＜0.001 ].The ERPs of the left and right atrium and ventricle in ablation group were significantly shorter as compared with that in the sham-operation group ( P＜0.05 in all).The inducibility of atrial tachycardia in ablation group was higher than that in the sham-operation group( P=0.041 ),but the inducibility of ventricular tachycardia between the two groups was comparable.Conclusion Atrial epicardial fat pad ablation only approach may be proarrhythmia in the long-term,especially in the level of atrium.