目的：探讨心房间隔单线消融防治心房颤动(AF)的可行性。

方法：选用13只闭胸犬，在静脉滴注乙酰甲胆碱下，用心房快速起搏诱发持续性AF(＞15分)。经皮穿刺静脉，在X线透视下用7F温控四极同步导管介导射频能量，消融卵圆窝前方的宽厚心房间隔。观察消融前后AF的诱发率及电生理参数。

结果：消融前所有犬均可诱发持续性AF，消融前2只犬死亡，间隔消融后8只犬不再诱发AF，1只犬诱发持续性房扑，消融三尖瓣环和下腔静脉间心肌后房扑消失。消融后检测的卵圆窝心房有效不应期较消融前延长(67±7 ms比113±9 ms,P＜0.05),其余部位无显著性差异。

结论：心房间隔单线消融能够防治实验性AF的发生，对于临床上有相似特点的AF消融心房间隔可能有效。

Effect of Simple Linear Septal Ablation on Eliminating Experimental Atrial Fibrillation in Dogs (Abstract)

Department of Cardiology, Beijing Red Cross Chaoyang Hospital, Capital University of Medical Sciences, Beijing (100020)

Liu Tong, Hu Dayi, Guo Chengjun, et al.

Objective: To test the hypothesis that a simplified septal linear ablation could be effective on eliminating atrial fibrillation (AF).

Methods: Thirteen dogs undergone temperature-controlled endocardial linear ablation across the thick septal portion in front of fossa ovalis (FO) at closed chest state. Sustained AF (＞15 minutes) was induced using burst pacing during iv infusion of methacholine. Electrophysiologic parameters were recorded before and after ablation.

Results: For the thirteen dogs under spetal ablation, two dogs died during methacholine infusion prior to ablation. Sustained AF became noninducible after septal ablation in 8 dogs during infusion of methacholine of 3.0 μg/kg per minute. After septal RFCA, on dog had sustained atrial flutter (＞15 minutes) induced by burst atrial pacing and no atrial flutter occured after a lesion between the tricuspid annulus and IVC was created. Sustained AF was still inducible by infusion of methacholine of a high dose in 2 dogs. The effective atrial refractory period was prolonged only in FO (67±7 ms vs. 113±9 ms, p＜0.05).

Conclusion: The results indicate the septal ablation may eliminate AF mediated by vagal activity. Ablation might also be useful for eliminating human AF with similar critical site at atrial septum.

卫生部自然科学基金和北京市科研基金资助项目