犬Marshall韧带的电生理学特点及其形态结构观察
Electrophysiological characteristic and morphologic observation of ligament of Marshall in dogs
王斌 1杜日映 1郑强荪 1赵玉 1凌凤东 2马福成3
作者信息
- 1. 第四军医大学唐都医院心内科,
- 2. 西安交通大学医学院解剖学教研室
- 3. 第四军医大学西京医院病理科
- 折叠
摘要
目的：观察Marshall韧带(LOM)的电生理学特点及其组织形态，探讨LOM在局灶性房颤发病机制中的地位。方法：选用健康犬8只，放置心内电极导管和心外膜电极，同步记录高位右房（HRA），左心耳（LAA），LOM的电活动。射频消融LOM靠近冠状窦的部位。比较消融前后HRA-LAA间期， HRA-LAM(左房)间期， HRA-LOM间期， LAM-LOM间期。切取LOM，进行组织学观察。结果：窦性心律时，在LOM上可以记录到双电位，前者是LAM电位，后者是LOM电位，消融LOM靠近冠状窦的部位，LOM电位消失，消融前后，HRA- LAA间期、HRA-LAM间期对比无显著性差异(P>0.05)。组织切片显示LOM内含有心肌组织，与深层左房肌被脂肪层隔离，脂肪层内含有大量的神经组织。结论：LOM电位是LOM内心肌组织产生的，LOM可能是局灶性房颤的起源部位之一。射频消融LOM靠近冠状窦的部位对左右房间传导无影响。对起源于LOM的局灶性房颤，消融这一部位可能有效。
Abstract
AIM: To investigate the roles of ligament of Marshall in mechanism of focal atrial fibrillation by studying the electrophysiological characteristic and morphology. METHODS: Eight healthy dogs were chosed. Epicardial electrodes and endocardial electrodes were placed. The electroactivities were recorded at high right atrium(HRA), left atrial appendage(LAA), ligament of marshall(LOM) synchronously. The part of ligament of Marshall near coronary sinus(CS) was ablated. HRA-LAA internal, HRA-left atrial muscle(LAM) internal, HRA-LOM internal, LAM-LOM internal were compared before and after ablation. LOMs were cut off, studied with histology method. RESULTS: Double electrical potentials (LAM potential and LOM potential) were recorded on ligament of Marshall in sinus rhythm. LOM potential disappeared after ablating the part of LOM near CS. HRA- LAA internal and HRA-LAM internal didn't change apparently after ablation. Morphologic observation suggested that there was cardiac muscle in the ligament of Marshall. There were a lot of nervous tissues near the ligament. CONCLUSION: LOM potential originates from the cardiac muscle in LOM. Ablation on the part of LOM near the CS doesn't influence conduction between left and right atrium. Some focal atrial fibrillations maybe result from LOM. It is possible to ablate the LOM to cure the focal atrial fibrillation by eliminating the LOM potential.
关键词
心房颤动,局灶性/Marshall韧带/射频消融/狗引用本文复制引用
出版年
2001
NETL
NSTL
维普
万方数据