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目的 为了建立一种全新的心房颤动 (房颤 )外科治疗手术方式 ,对 5只杂种犬实行了窦性冲动疏导术。 方法 5只杂种犬开胸后在心外膜行短阵快速刺激 (burst) ,其中 2只诱导出房颤 ,3只诱导出心房扑动 (房扑 )。然后实行窦性冲动疏导术。手术方法是将右房切口设计为界嵴 (cristaterminalis)前、后两切口以及自右心耳终止于三尖瓣环的切口 ,以保护前、后结间束、窦房结动脉和右房上部的窦性冲动发生区。左房切口为一连接各肺静脉口的“υ”字形切口 ,以保护左房的正常传导通路和窦房结动脉。这一左房的υ形切口终止于二尖瓣环 ,不会围绕左房切口线形成新的折返激动。 结果 术后原条件行短阵快速刺激不能诱发出房颤或房扑。PR间期正常 ,左、右房收缩同步。左房后壁收缩良好。 结论 窦性冲动疏导术后使窦性冲动传导和左房输送功能达到更好的恢复 ,还使手术更容易实施。
Objective To establish a new surgical treatment of atrial fibrillation (AF), 5 dogs were treated with sinus impulse grooming. Methods Five hybrid dogs were rapidly burst on the epicardium after thoracotomy, of which two induced atrial fibrillation and three induced atrial flutter (atrial flutter). Then the implementation of sinus impulse dredging surgery. Surgical approach is the design of the right atrium incision as the crest (cristaterminalis) before and after the two incisions and since the right atrial appendage termination of the tricuspid annulus incision, in order to protect the anterior and posterior junction bundle, the sino-atrial node artery and the right atrium Sinus impulse occurred area. Left atrial incision for the connection of each pulmonary vein port “υ” shaped incision, in order to protect the left atrium normal conduction pathway and the sino-atrial node artery. The υ-shaped incision in the left atrium terminates in the mitral valve annulus and does not create a new reentry activation around the left atrial incision line. Results After the original condition of the line array fast stimulation can not induce atrial fibrillation or atrial flutter. PR interval is normal, left and right atrial contraction synchronization. Left atrial wall contraction good. CONCLUSIONS: Sinus dredging facilitates sinus impulse conduction and left atrial delivery to achieve better recovery, and makes surgery easier to perform.