CAJ | 학술논문

目的评估不同电生理刺激方案对犬Marshall电位的影响.方法成年杂种犬15只暴露Marshall韧带,Lasso电极导管置于韧带上方记录Marshall电位.分别于左心耳、右心耳处予以电生理刺激.记录Marshall电位及心房-Marshall电位间期(AM间期).随机选择10只犬组织学检查明确Marshall韧带肌束(Marshall束)与心房间解剖连接(组1为无连接,组2为有连接).余5只犬酒精消融Marshall韧带(组3).结果组1共6只犬,1只犬窦性心律下未记录到Marshall电位,但在左心耳刺激时Marshall电位从左心房电位中分离出来.5只犬窦性心律下记录到Marshall电位,左心耳刺激时AM间期延长(＞20 ms)[(125±9)ms vs(80 ±6)ms,P=0.043,左心耳刺激=350 ms;(126±9)ms vs(80±6)ms,P=0.044,左心耳刺激=450 ms].组2共4只犬,2只犬窦性心律下未记录到Marshall电位,左心耳刺激时可见Marshall电位从左心房电位中分离出来.2只犬窦性心律下记录到Marshall电位,左心耳刺激时AM间期可延长,但亦可缩短.组3犬窦性心律或左心耳刺激下记录到Marshall电位,酒精消融Marshall韧带后,Marshall电位消失.结论与窦性心律比较,左心耳刺激时,Marshall电位呈现多种形式,包括AM间期延长.后者对Marshall韧带消融有益.
목적 평고불동전생리자격방안대견Marshall전위적영향.방법 성년잡충견15지폭로Marshall인대,Lasso전겁도관치우인대상방기록Marshall전위.분별우좌심이、우심이처여이전생리자격.기록Marshall전위급심방-Marshall전위간기(AM간기).수궤선택10지견조직학검사명학Marshall인대기속(Marshall속)여심방간해부련접(조1위무련접,조2위유련접).여5지견주정소융Marshall인대(조3).결과 조1공6지견,1지견두성심률하미기록도Marshall전위,단재좌심이자격시Marshall전위종좌심방전위중분리출래.5지견두성심률하기록도Marshall전위,좌심이자격시AM간기연장(＞20 ms)[(125±9)ms vs(80 ±6)ms,P=0.043,좌심이자격=350 ms;(126±9)ms vs(80±6)ms,P=0.044,좌심이자격=450 ms].조2공4지견,2지견두성심률하미기록도Marshall전위,좌심이자격시가견Marshall전위종좌심방전위중분리출래.2지견두성심률하기록도Marshall전위,좌심이자격시AM간기가연장,단역가축단.조3견두성심률혹좌심이자격하기록도Marshall전위,주정소융Marshall인대후,Marshall전위소실.결론 여두성심률비교,좌심이자격시,Marshall전위정현다충형식,포괄AM간기연장.후자대Marshall인대소융유익.
Objective The aim of this study is to research the electrophysiological characteristics of the ligament of Marshall. Methods Fifteen mongrel dogs were studied. An electrode catheter was positioned over the ligament of Marshall (LOM) to record the Marshall potential during sinus rhythm and different protocols of atrial appendage pacing. Histological examination was performed to determine if histological connections between the Marshall bundle (MB) and left atrium (LA) were presented in these 10 dogs, which were divided into 2 groups based on histological connection or no histological connection. Ablation of the LOM was performed in the rest five dogs. Results In first ten dogs, six of them had no histological connection between LA and MB (group 1), and the other four had the histological connections between LA and MB (group 2). The Marshall potentials were recorded in five dogs under sinus rhythm in group 1, and the atrial-Marshall potential (AM) intervals were prolonged significantly by left atrium appendage (LAA) pacing at 350 ms[ (125 ± 9) ms vs (80± 6) ms,P = 0. 043 ] and at 450 ms[ (126 ± 9) ms vs (80 ± 6) ms,P = 0. 044 ], but not prolonged during RAA pacing(P ＞ 0.05). In the rest one dog of group 1, the Marshall potential was not recorded separately under sinus rhythm or under right atrium appendage (RAA) pacing but could be separated from LA electrograms by LAA pacing. The Marshall potentials were recorded in two dogs under sinus rhythm In group 2. AM interval could also he prolonged by LAA pacing, but it could he shortened yet. In addition, the AM interval wasn't changed significantly during RAA pacing. In the rest two dogs of Group 2, the Marshall potential wash' t seen under sinus rhythm or during RAA pacing but could be separated from LA electrogram during LAA pacing. The Marshall potentials were recorded in three dogs under sinus rhythm and two dogs under LAA pacing in group 3. All Marshall potentials recorded in group 3 were eliminated by LOM ablation. Conclusion Marshall potential has different electrograms including the prolonged AM interval, which would be presented by LAA pacing. This might facilitate the LOM ablation.