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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Relation between the pacing induced sequence of activation and left ventricular pump function in animals.
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Relation between the pacing induced sequence of activation and left ventricular pump function in animals.

机译：起搏诱导的激活序列与动物左心室泵功能之间的关系。

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摘要

The main goal of this article was to review animal experimental work on the effect of asynchronous activation on ventricular pump function. During normal sinus rhythm and atrial pacing, the Purkinje system contributes significantly to the rapid electrical activation of the ventricles. In contrast, during ventricular pacing the impulse is almost exclusively conducted through the normal myocardium. As a consequence, electrical activation of the ventricles becomes asynchronous and has an abnormal sequence. The abnormal impulse conduction causes considerable disturbances to occur in regional systolic fiber shortening, mechanical work, blood flow, and oxygen consumption; low values occurring in early activated regions and values above normal being present in late activated regions. Many animal studies have now shown that the abnormal electrical activation, induced by ventricular pacing, leads to a depression of systolic and diastolic LV function. Pacing at the right ventricular apex (the conventional pacing site) reduces LV function more than pacing at the high ventricular septum or at LV sites. In canine hearts with experimental LBBB, LV pacing significantly improves LV pump function. Differences in LV pump function between (combinations of) pacing sites are poorly correlated with QRS duration. Therefore, the cause of the depression of LV function during abnormal electrical activation appears to be a combination of the asynchrony and the sequence of activation. These experimental findings justify continuing attention for optimizing the site(s) of ventricular pacing in patients with normal and abnormal ventricular impulse conduction.
机译：本文的主要目的是回顾动物实验工作对异步激活对心室泵功能的影响。在正常的窦性心律和心房起搏过程中，浦肯野系统对心室的快速电激活起重要作用。相反，在心室起搏期间，脉冲几乎仅通过正常心肌进行。结果，心室的电激活变得异步并且具有异常序列。异常的脉冲传导会引起局部收缩纤维缩短，机械功，血流和耗氧量的大量干扰。低值出现在早期激活区域，而高于正常值出现在晚期激活区域。现在许多动物研究表明，由心室起搏引起的异常电激活导致收缩压和舒张压LV功能降低。在右心室顶点起搏（常规起搏部位）比在高室间隔或左心室部位起搏更能降低左室功能。在具有实验性LBBB的犬心脏中，LV起搏可显着改善LV泵功能。起搏部位之间（的组合）LV泵功能的差异与QRS持续时间的相关性很差。因此，异常电激活期间LV功能降低的原因似乎是异步和激活顺序的组合。这些实验结果证明继续关注优化具有正常和异常心室冲动传导的患者的心室起搏部位。

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