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本文采用同步双标测法,研究了窦房结(SN)优势起搏点兴奋向心房传导的规律。在14只麻醉狗心脏界沟部缝上一装有32个电极的电极板,标测优势起搏点(P点),最早起始负电位点(N点),心房激动过程图及最早激动点(O点)。在用异丙肾上腺索、心得安或刺激迷走神经使P点移位后,我们研究了P点位置与P—O、P—N的关系。在计60次实验中:(1)P—O、P—N多数并不重叠(分别为46次和40次);(2)随着P点从SN头部向尾部移位,O(N)点在P点头侧的出现率下降,在P点尾侧的出现率上升;(3)出现两个O点者23次,出现两个N点者11次,但P点始终只有一个。 本文提出了SN兴奋在SN内优先向头、尾两端扩布,再传向心房肌的窦房传导模式。并对心房激动多中心起源、界沟部兴奋超速传导等现象及Boiaeau的“心房综合起搏”假说进行了讨论。
In this paper, synchronous dual-labeled method was used to study the regularity of the affection of the superior ventricular node (SN) to atrial conduction. Electrode plates with 32 electrodes were stitched on the fourteen anesthetized dogs in the ditch of the heart, and the dominant pacing points (P points), the earliest negative potential point (N points), the atrial activation process and the earliest activation Point (O point). After using isoprenaline, propofol or vagus nerve to shift the P point, we studied the relationship between the P point and P-O and P-N. In 60 experiments, (1) P-O and P-N did not overlap (46 times and 40 times, respectively); (2) As P shifted from SN head to tail, ) Point in the nodal P side of the incidence of decline in the tail point of the P-point incidence increased; (3) appeared two O-point 23 times, there are two N-point 11 times, but only one point P. In this paper, we propose that SN excitement preferentially spreads to the head and tail in the SN and then transmits to the sphincter of atrium. We also discuss the origin of atrial activation multicentric centers, the phenomenon of hyperextension conduction in the border ditch and Boiaeau’s “atrial pacing” hypothesis.