Name: sterile pericarditis in aachener minipigs as a model for atrial myopathy and atrial fibrillation
Uploaded: 2021-09-24T15:00:00
Description: Watch this Scientific Journal Video about Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation at JoVE.com

这项工作得到了安特卫普大学 Industrieel OnderzoeksFonds/Strategisch Basisonderzoek （IOF/SBO）研究资助（PID34923）和 Geconcerteerde Onderzoeksactie （GOA）资助（PID36444）的支持。由高级临床研究员奖学金（VFS）和法兰德斯科学研究基金的研究补助金（申请号1842219N，G021019N，G0D0520N和G021420N）;由 ERA.Net RUS Plus（2018年，项目联盟278）的研究资助;作者： Vlaamse Interuniversitaire Raad/Interuniversitair Bijzonder OnderzoeksFonds （VLIR/iBOF） grant （20-VLIR-iBOF-027）.我们感谢雅培和波士顿科学公司赞助了大部分起搏器负责人，并感谢美敦力和Biotronik公司借出一名心脏起搏器程序员。我们感谢安特卫普大学动物设施的动物工作人员对动物的出色照顾。

该协议已获得安特卫普大学动物试验伦理委员会（病例号2019-29）的批准，并遵循安特卫普大学的动物护理指南。本研究选择了17只6个月大的Aachener迷你猪（雄性，阉割），体重约为20公斤。
1. 药物和麻醉
<ol><li>用药前<ol>
<li>确保猪禁食12小时，但无限制地获得水。</li>
		<li>对于镇静剂，在一次肌内注射中施用以下药物：阿托品0.05mg / kg，氯胺酮10mg / kg，咪达唑仑0.5mg / kg。</li>...

<ol>
	<li>Hindricks, G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=2020+ESC+Guidelines+for+the+diagnosis+and+management+of+atrial+fibrillation+developed+in+collaboration+with+the+European+Association+for+Cardio-Thoracic+Surgery+(EACTS):+The+Task+Force+for+the+diagnosis+and+management+of+atrial+fibrillation+of+the+European+Society+of+Cardiology+(ESC)+Developed+with+the+special+contribution+of+the+European+Heart+Rhythm+Association+(EHRA)+of+the+ESC.">2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC.</a> European Heart Journal. 42 (5), 373 (2021).</li><li>Sajeev, J. K., Kalman, J. M., Dewey, H., Cooke, J. C., Teh, A. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+atrium+and+embolic+stroke:+myopathy+not+atrial+fibrillation+as+the+requisite+determinant.">The atrium and embolic stroke: myopathy not atrial fibrillation as the requisite determinant.</a> JACC. Clinical Electrophysiology. 6 (3), 251-261 (2020).</li><li>Shen, M. J., Arora, R., Jalife, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Atrial+myopathy.">Atrial myopathy.</a> JACC: Basic to Translational Science. 4 (5), 640-654 (2019).</li><li>Jalife, J., Kaur, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Atrial+remodeling,+fibrosis,+and+atrial+fibrillation.">Atrial remodeling, fibrosis, and atrial fibrillation.</a> Trends in Cardiovascular Medicine. 25 (6), 475-484 (2015).</li><li>Fu, X. X., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Interleukin-17A+contributes+to+the+development+of+post-operative+atrial+fibrillation+by+regulating+inflammation+and+fibrosis+in+rats+with+sterile+pericarditis.">Interleukin-17A contributes to the development of post-operative atrial fibrillation by regulating inflammation and fibrosis in rats with sterile pericarditis.</a> International Journal of Molecular Medicine. 36 (1), 83-92 (2015).</li><li>Liao, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=TRPV4+blockade+suppresses+atrial+fibrillation+in+sterile+pericarditis+rats.">TRPV4 blockade suppresses atrial fibrillation in sterile pericarditis rats.</a> JCI Insight. 5 (23), 137528 (2020).</li><li>Zhang, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Role+of+inflammation+in+the+initiation+and+maintenance+of+atrial+fibrillation+and+the+protective+effect+of+atorvastatin+in+a+goat+model+of+aseptic+pericarditis.">Role of inflammation in the initiation and maintenance of atrial fibrillation and the protective effect of atorvastatin in a goat model of aseptic pericarditis.</a> Molecular Medicine Reports. 11 (4), 2615-2623 (2015).</li><li>Vizzardi, E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Risk+factors+for+atrial+fibrillation+recurrence:+a+literature+review.">Risk factors for atrial fibrillation recurrence: a literature review.</a> Journal of Cardiovascular Medicine. 15 (3), 235-253 (2014).</li><li>Dosdall, D. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Chronic+atrial+fibrillation+causes+left+ventricular+dysfunction+in+dogs+but+not+goats:+experience+with+dogs,+goats,+and+pigs.">Chronic atrial fibrillation causes left ventricular dysfunction in dogs but not goats: experience with dogs, goats, and pigs.</a> American Journal of Physiology. Heart and Circulatory Physiology. 305 (5), 725-731 (2013).</li><li>Schuttler, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Animal+models+of+atrial+fibrillation.">Animal models of atrial fibrillation.</a> Circulation Research. 127 (1), 91-110 (2020).</li><li>Wijffels, M. C., Kirchhof, C. J., Dorland, R., Allessie, M. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Atrial+fibrillation+begets+atrial+fibrillation.+A+study+in+awake+chronically+instrumented+goats.">Atrial fibrillation begets atrial fibrillation. A study in awake chronically instrumented goats.</a> Circulation. 92 (7), 1954-1968 (1995).</li><li>Willems, R., Ector, H., Holemans, P., Van De Werf, F., Heidbuchel, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+different+pacing+protocols+on+the+induction+of+atrial+fibrillation+in+a+transvenously+paced+sheep+model.">Effect of different pacing protocols on the induction of atrial fibrillation in a transvenously paced sheep model.</a> Pacing and Clinical Electrophysiology. 24 (6), 925-932 (2001).</li><li>Pag&#233;, P. L., Plumb, V. J., Okumura, K., Waldo, A. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+new+animal+model+of+atrial+flutter.">A new animal model of atrial flutter.</a> Journal of the American College of Cardiology. 8 (4), 872-879 (1986).</li><li>Schwartzman, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+plasma-based,+amiodarone-impregnated+material+decreases+susceptibility+to+atrial+fibrillation+in+a+post-cardiac+surgery+model.">A plasma-based, amiodarone-impregnated material decreases susceptibility to atrial fibrillation in a post-cardiac surgery model.</a> Innovations. 11 (1), 59-63 (2016).</li><li>BCFI vzw. Vetcompendium BCFIvet Available from: <a target="_blank" href="https://www.vetcompendium.be/nl">https://www.vetcompendium.be/nl</a> (2021)</li><li>Swindle, M. M., Smith, A. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Swine in the laboratory. Surgery, anesthesia, imaging, and experimental techniques, Third edition. , (2016).</li><li>Unit for Laboratory Animal Medicine. Guidelines on anesthesia and analgesia in swine Available from: <a target="_blank" href="https://az.research.umich.edu/animalcare/guidelines/guidelines-anesthesia-and-analgesia-swine">https://az.research.umich.edu/animalcare/guidelines/guidelines-anesthesia-and-analgesia-swine</a> (2021)</li><li>Ettrup, K. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Basic+surgical+techniques+in+the+Gottingen+minipig:+intubation,+bladder+catheterization,+femoral+vessel+catheterization,+and+transcardial+perfusion.">Basic surgical techniques in the Gottingen minipig: intubation, bladder catheterization, femoral vessel catheterization, and transcardial perfusion.</a> Journal of Visualized Experiments: JoVE. (52), e2652 (2011).</li></ol>

可靠的大型动物模型是研究心房肌病和心房颤动以及开发心房颤动新疗法的主要资产。在心房心髁上植入起搏器导联允许纵向随访和重复的电生理学检查，这在小动物中是困难的。迷你猪很容易处理，它们的心脏在结构和生理上与人类的心脏相似10。
与连续心房快速检查相比，无菌性心包炎模型相对简单，因为不需要定制的程序化起搏器。该模型中诱导的病...

心房颤动 （AF） 是最常见的心律失常，可导致显著的发病率、死亡率和医疗费用1。在许多情况下，心房颤动仅仅是潜在心房肌病的电症状，其定义为心房的结构、电、自主神经和收缩性重塑。这种心房肌病可导致心房颤动和中风2，3。大多数疗法仅针对电重塑，但不针对心房的潜在结构变化（炎症和纤维化）4，5，6，7。这可能是为什么目前的疗法只有轻微的效果的原因之一，特别是在更晚期的心房肌病8中。
可重复的动物模型对于靶向心房肌病中存在的炎症和纤维化至关重要。在几种大型动物物种中已经开发了心房快速模型9，10，11，12。在这些模型中，心房组织长时间连续调整以诱导电和最终的结构变化。快速分析模型的主要缺点是心房肌病结构性体征出现之前的持续时间较长，并且它们仅与心房肌病前发生电异常的临床综合征相关。理论上的风险是长时间随访期间纤维化导致的起搏-先导衰竭9.
在无菌性心包炎模型中，无菌滑石粉喷洒在心房的心外膜表面以诱导急性炎症和纤维化反应，导致心房肌病13，14。猪的心脏解剖结构和生理学与人类相似，因此猪模型具有很高的转化相关性。使用迷你猪的优点是，由于它们的尺寸比传统的猪品系小，它们更容易处理，并且可以长时间保持而不会显着增加体重10。所有这些原因使迷你猪的无菌性心包炎成为研究心房肌病和颤动的极好模型。该协议和视频旨在促进该模型在不同研究设施中的设置，并标准化协议以研究心房颤动的诱导性。

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>Aachener minipig, 6-months old, male, castrated, weight 15-25 kg</td>
			<td>Carfil</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Anesthesia and preparation</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>ECG electrodes</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Endotracheal tube 6.5 mm ID</td>
			<td>Covidien</td>
			<td>115-65OR</td>
			<td></td>
		</tr>
		<tr>
			<td>External cardioverter-defibrillator</td>
			<td>Innomed</td>
			<td>Cardio-aid 200B</td>
			<td></td>
		</tr>
		<tr>
			<td>Heating pad</td>
			<td>OK.</td>
			<td>OUB 60321</td>
			<td></td>
		</tr>
		<tr>
			<td>Intravenous catheter 22 GA, 1 Inch</td>
			<td>BD</td>
			<td>381323</td>
			<td></td>
		</tr>
		<tr>
			<td>Laryngoscope blade size 4</td>
			<td>Miller</td>
			<td>SUS426601</td>
			<td></td>
		</tr>
		<tr>
			<td>Monitor</td>
			<td>GE Medical systems</td>
			<td>2600040-003</td>
			<td></td>
		</tr>
		<tr>
			<td>Respirator</td>
			<td>Datex-Ohmeda</td>
			<td>1009-9000-000</td>
			<td></td>
		</tr>
		<tr>
			<td>Shaver</td>
			<td>Aesculap</td>
			<td>GT 104 / REF 985203</td>
			<td></td>
		</tr>
		<tr>
			<td>Syringe driver pump</td>
			<td>Fresenius Kabi</td>
			<td>082470</td>
			<td></td>
		</tr>
		<tr>
			<td>Arterial and central venous line placement</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>3-lumen central venous catheterization set, 7 French, 16 cm, 0.032 Inch guide</td>
			<td>Arrow medical</td>
			<td>EU-22703-EN</td>
			<td></td>
		</tr>
		<tr>
			<td>Arteral catheter 3 French, 8 cm</td>
			<td>Vygon</td>
			<td>1,15,090</td>
			<td></td>
		</tr>
		<tr>
			<td>Caresite Luer access device</td>
			<td>B. Braun</td>
			<td>415122-01</td>
			<td></td>
		</tr>
		<tr>
			<td>Fluids: IV bags of Plasmalyte, Glucose 5%, NaCl 0.9% (500 mL or 1000 mL)</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>heparinized saline</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Needles: 18 Ga / 40 mm and 22 Ga / 40 mm</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Pressure monitoring set, 195 cm</td>
			<td>Edwards Lifesciences</td>
			<td>T005021M</td>
			<td></td>
		</tr>
		<tr>
			<td>Pressure tubing 180 cm</td>
			<td>Edwards Lifesciences</td>
			<td>50P172</td>
			<td></td>
		</tr>
		<tr>
			<td>suture with needle</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Syringes Luerlok: 2 mL, 5 mL, 10 mL, 20 mL, 50 mL</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Ultrasound gel</td>
			<td>Zealand coating</td>
			<td>446-1</td>
			<td></td>
		</tr>
		<tr>
			<td>Ultrasound with vascular probe</td>
			<td>Philips healthcare</td>
			<td>EPIQ 7C / REF BZE1723</td>
			<td></td>
		</tr>
		<tr>
			<td>Surgical set</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Blunt-tip surgical scissors</td>
			<td>Martin</td>
			<td>11-934-25</td>
			<td></td>
		</tr>
		<tr>
			<td>60 degrees curved Debakey forceps</td>
			<td>Aesculap</td>
			<td>FB403</td>
			<td></td>
		</tr>
		<tr>
			<td>Anatomical forceps</td>
			<td>AS</td>
			<td>13-102-16</td>
			<td></td>
		</tr>
		<tr>
			<td>Debakey forceps</td>
			<td>Geister</td>
			<td>10-0634</td>
			<td></td>
		</tr>
		<tr>
			<td>Electrocautery module</td>
			<td>Alsa</td>
			<td>Alsatom SU 140/D MPC</td>
			<td></td>
		</tr>
		<tr>
			<td>Holders for stainless steel wire</td>
			<td>COBE</td>
			<td>013-123</td>
			<td></td>
		</tr>
		<tr>
			<td>Mosquito</td>
			<td>Leibinger</td>
			<td>32-01008</td>
			<td></td>
		</tr>
		<tr>
			<td>Needledriver, fine</td>
			<td>Delacroix-Chevalier</td>
			<td>50302-21</td>
			<td></td>
		</tr>
		<tr>
			<td>Needledriver, normal</td>
			<td>Aesculap</td>
			<td>BM 77</td>
			<td></td>
		</tr>
		<tr>
			<td>Rib spreader</td>
			<td>Martin</td>
			<td>24-178-01</td>
			<td></td>
		</tr>
		<tr>
			<td>Scalpel</td>
			<td>Swann-Morton</td>
			<td>0511</td>
			<td>no. 24</td>
		</tr>
		<tr>
			<td>Scissors for stainless steel wire</td>
			<td>Jakobi</td>
			<td>411830</td>
			<td></td>
		</tr>
		<tr>
			<td>Spreaders</td>
			<td>AS</td>
			<td>16-058-00</td>
			<td></td>
		</tr>
		<tr>
			<td>Sternum saw</td>
			<td>Eure-Power</td>
			<td>5000020</td>
			<td></td>
		</tr>
		<tr>
			<td>Sternum saw blade</td>
			<td>MicroAire</td>
			<td>ZR-032M</td>
			<td></td>
		</tr>
		<tr>
			<td>Surgical consumables</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Disinfectant: iodine, chlorhexidine</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Electrocautery pencil with push button, cable 5 m</td>
			<td>Dongguan QueenMed Equipment</td>
			<td>ESPB4001LQ</td>
			<td></td>
		</tr>
		<tr>
			<td>Gastric tube</td>
			<td>Vygon</td>
			<td>390.12</td>
			<td></td>
		</tr>
		<tr>
			<td>Mersilene-0, 75 cm</td>
			<td>Ethicon</td>
			<td>F2505H</td>
			<td></td>
		</tr>
		<tr>
			<td>Monocryl 3-0, 70 cm</td>
			<td>Ethicon</td>
			<td>Y423H</td>
			<td></td>
		</tr>
		<tr>
			<td>Mouth masks, hair nets</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Oriflex-4 vacuum flask for surgical draining</td>
			<td>Oriplast Krayer</td>
			<td>VK00352</td>
			<td></td>
		</tr>
		<tr>
			<td>Prolene 6-0, 75 cm</td>
			<td>Ethicon</td>
			<td>8711H</td>
			<td></td>
		</tr>
		<tr>
			<td>Stainless steel monofilament non-absorbable suture</td>
			<td>Ethicon</td>
			<td>W995</td>
			<td></td>
		</tr>
		<tr>
			<td>Sterile drapes</td>
			<td>3M</td>
			<td>9010</td>
			<td></td>
		</tr>
		<tr>
			<td>Sterile gauze 20 x 10 cm</td>
			<td>Stella</td>
			<td>35921</td>
			<td></td>
		</tr>
		<tr>
			<td>Sterile gloves</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Sterile surgical gown</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Steritalc PF3</td>
			<td>Novatech</td>
			<td>16863</td>
			<td></td>
		</tr>
		<tr>
			<td>Vicryl-0, 75 cm</td>
			<td>Ethicon</td>
			<td>V324H</td>
			<td></td>
		</tr>
		<tr>
			<td>Cardiac pacing</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Bipolar pacing lead Fineline II Sterox EZ 58 cm</td>
			<td>Boston Scientific</td>
			<td>4474</td>
			<td></td>
		</tr>
		<tr>
			<td>Bipolar pacing lead Tendril STS 58 cm</td>
			<td>Abbott</td>
			<td>2088TC</td>
			<td></td>
		</tr>
		<tr>
			<td>Ellegaard G&#246;ttingen Minipig Frame 3</td>
			<td>Lomir</td>
			<td>DF H1PU</td>
			<td></td>
		</tr>
		<tr>
			<td>Ellegaard G&#246;ttingen Minipig Sling Cover</td>
			<td>Lomir</td>
			<td>SS CEG1</td>
			<td></td>
		</tr>
		<tr>
			<td>Micropace cardiac stimulator</td>
			<td>Boston Scientific</td>
			<td>EPS 320</td>
			<td></td>
		</tr>
		<tr>
			<td>Pacemaker for pacing</td>
			<td>Medtronic</td>
			<td>Azure XT DR MRI SureScan</td>
			<td></td>
		</tr>
		<tr>
			<td>Pacemaker for sensing</td>
			<td>Biotronik</td>
			<td>Eluna 8 DR-T</td>
			<td></td>
		</tr>
		<tr>
			<td>Pacemaker programmer for pacing</td>
			<td>Medtronic</td>
			<td>CareLink Encore 29901A</td>
			<td></td>
		</tr>
		<tr>
			<td>Pacemaker programmer for sensing</td>
			<td>Biotronik</td>
			<td>ICS 3000 DS CD-W US</td>
			<td></td>
		</tr>
		<tr>
			<td>Medication</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Adrenaline 1 mg/mL, 1 mL</td>
			<td>Sterop</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Atropine 0.5 mg/mL, 1 mL</td>
			<td>Sterop</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Catapressan 150 &#181;g/mL, 1 ml clonidine</td>
			<td>Boehringer Ingelheim</td>
			<td>BE021402</td>
			<td></td>
		</tr>
		<tr>
			<td>Cefazoline 2 g powder</td>
			<td>Mylan</td>
			<td>BE319794</td>
			<td></td>
		</tr>
		<tr>
			<td>Cordarone 50 mg/mL, 3 mL amiodarone</td>
			<td>Sanofi</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Durogesic 50 &#181;g/h fentanyl patches</td>
			<td>Janssen-Cilag</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Glucose 5%, 500 mL</td>
			<td>Baxter</td>
			<td>AE0063</td>
			<td></td>
		</tr>
		<tr>
			<td>Ketalar 50 mg/mL, 10 mL</td>
			<td>Pfizer</td>
			<td>804101</td>
			<td></td>
		</tr>
		<tr>
			<td>Lanoxin 0.25 mg/mL, 2 mL digoxine</td>
			<td>Aspen</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Marcaine 0.5% + adrenaline 1:200,000</td>
			<td>Aspen</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Midazolam 5 mg/ml, 3 mL</td>
			<td>B. Braun</td>
			<td>3521740</td>
			<td></td>
		</tr>
		<tr>
			<td>Morfine 10 mg/mL, 1 mL</td>
			<td>Sterop</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>NaCl 0.9%, 500 mL</td>
			<td>Baxter</td>
			<td>AKE1323</td>
			<td></td>
		</tr>
		<tr>
			<td>Nitro Pohl 1 mg/mL, 5 mL nitroglycerine</td>
			<td>Pohl Boskamp</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Noradrenaline 1 mg/mL, 4 mL</td>
			<td>Aguettant</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Plasmalyte 1000 mL</td>
			<td>Baxter</td>
			<td>AKE0324</td>
			<td></td>
		</tr>
		<tr>
			<td>Propofol 10 mg/mL, 20 mL</td>
			<td>B. Braun</td>
			<td>3521810</td>
			<td></td>
		</tr>
		<tr>
			<td>Protamine 1400 IU/mL, 5 mL</td>
			<td>Leo pharma</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Rapifen 0.5 mg/mL, 2 mL</td>
			<td>Janssen-Cilag</td>
			<td>95103</td>
			<td></td>
		</tr>
		<tr>
			<td>Seloken 1 mg/mL, 5 mL metoprolol</td>
			<td>AstraZeneca</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Sevorane Quick Fill 100% sevoflurane, 250 mL</td>
			<td>Abbvie</td>
			<td>1283-415</td>
			<td></td>
		</tr>
		<tr>
			<td>Tracrium 10 mg/mL, 5 mL atracurium</td>
			<td>Aspen</td>
			<td></td>
			<td></td>
		</tr>
	</tbody>
</table>

sterile pericarditis in aachener minipigs as a model for atrial myopathy and atrial fibrillation

心房颤动（AF）是由心房结构重塑引起的最常见的心律失常，也称为心房肌病。目前的治疗仅针对电异常，而不是潜在的心房肌病。对于新疗法的开发，需要可重复的心房肌病大型动物模型。本文介绍了Aachener minipigs中无菌性心包炎诱导的心房肌病模型。无菌性心包炎是通过喷洒无菌滑石并在心房心外膜表面留下一层无菌纱布引起的。这导致了炎症和纤维化，这是心房肌病病病理生理学的两个关键组成部分，使心房容易受到心房颤动的诱导。两个起搏器电极被心外膜放置在每个心房上，并连接到来自不同制造商的两个起搏器。该策略允许重复的非侵入性心房程序性刺激，以确定术后特定时间点心房颤动的诱导性。使用不同的方案来测试心房颤动诱导性。该模型的优点是其临床相关性，具有心房颤动诱导性和炎症和纤维化的快速诱导 - 均存在于心房肌病中 - 及其可重复性。该模型将有助于开发针对心房肌病和心房颤动的新疗法。

发病率和死亡率： 当我们开始在Aachener minipigs中开发这种无菌性心包炎模型时，我们注意到17头猪中有4头（23.5%）的围手术期死亡率为4只（23.5%）：由于“学习曲线效应”，4例死亡中有3例发生在前6次手术中。病因如下：2头猪因术后呼吸骤停而死亡;这个问题通过减少阿芬太尼的剂量得到解决。一头猪在第一次起搏过程中因心室颤动而死亡，一头在起搏导联测试期间死亡：这是由于?...

Watch this Scientific Journal Video about Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation at JoVE.com

Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation

我们描述了一种在迷你猪中无菌性心包炎模型来研究心房肌病和心房颤动（AF）。我们介绍了手术和麻醉技术，血管通路策略以及研究心房颤动诱导性的方案。

Aachener Minipigs的无菌性心包炎作为心房肌病和心房颤动的模型

Atrial fibrillation (AF) is the most common arrhythmia caused by structural remodeling of the atria, also called atrial myopathy. Current therapies only ...

心房肌病可导致心房颤动，这是人类最常见的心律失常。无菌性心包炎模型是一种可靠的大型动物模型，类似于心房肌病的发病机制。该模型可在几周内快速诱导心房肌病。此外，在随访期间可以很容易地进行重复的电生理学研究，而无需重复的导管插入。由于解剖学和生理学与人类相比相似，这里介绍的minipig模型可用于研究心房肌病和心房颤动的病理生理学，但也可用于临床前药物发现。首先准备传压系统。将5， 000国际单位的肝素加入静脉注射袋中，加入500毫升0.9%盐水。将动物置于仰卧位，然后伸展腿部，在颈动脉设置中使用超声和血管探针定位股动脉。用氯己定消毒腹股沟区。使用超声引导穿刺股动脉，并使用Seldinger技术插入3法式鞘。用缝合线固定护套，并将其连接到传感器以冲洗。实时监测动脉血压。在胸锁乳突肌内侧缘的凹槽中做一个五厘米的切口。然后钝性解剖，直到到达颈内静脉。去除静脉周围的纤维组织，并在所需的导管插入部位周围放置Prolene 6 x 0平方缝合线，以获得血管控制。使用Seldinger技术，用3个法国三腔CVC卡压颈内静脉。然后收紧导管周围的Prolene 6-0缝合线。将导管的手柄固定在胸锁乳突肌上。将三根导管腔分开隧道，并将末端牢固地连接到皮肤上。放在无针注射口，然后将切口部位两层关闭。将胸骨的正中切口手部射孔到剑突下方三厘米处，直到胸骨变得明显。从 xiphoid 过程中钝地从尾部剖析。将手指或钝的解剖剪刀放在胸骨的内脏侧，并尽可能沿着内脏胸骨表面去除结缔组织。使用胸骨锯切开胸骨。然后使用胸骨扩张器扩大胸腔的通道，避免损伤胸膜。小心打开心包，并使用悬浮缝合线将其挡在手术场之外。测试引线固定螺钉的拉伸和缩回机构后，将引线尖端放在弯曲的镊子上，并在必要时将样式弯曲60度。在左心室敷上，轻轻将其拉到一边，以获得左心房的视野。在左心房的可视化后，将铅尖牢固地放在其壁上，尽可能靠近肺静脉并尽可能远离心室。通过将螺旋延伸到心房组织将其拧入，最好是稍微倾斜。快速工作并立即释放左心室的压力。使用可编程电刺激器或起搏器程序测量引线的感应和起搏阈值以及阻抗。确保在高电压下起搏时没有心室过度捕获。在右心房放置起搏器导线，完全类似于左心房导联的位置。确保两根导线都将胸部留在中线。左心房导联必须通过腹部皮下脂肪从剑突隧道到左翼，右心房导线到右心房导线到右侧。在猪的左右侧皮下脂肪中做一个起搏器口袋。将能够执行50赫兹爆发起搏的起搏器与左心房导线连接，并将来自其他制造商的起搏器与右心房导线连接，然后将其放在口袋内。通过轻轻拉开心室再次暴露心房，然后用纱布覆盖心室。使用分配器将无菌滑石粉喷洒在两个心房的心外膜表面上。在心房的心外膜表面上留下一层无菌纱布。在开始闭合之前，最后一次检查起搏器引线的位置。使用单晶3-0关闭心包，使用不锈钢丝关闭胸骨，然后分别使用Vicryl Zero和Monocryl 3-0进行皮下和皮肤闭合。胸骨伤口愈合后，再次称量猪的体重以进行随访，然后将动物放在约束吊带中并将其带到手术室。附加心电图和饱和度监测，并将编程器头放在相应的起搏器上。询问起搏器。检查起搏器设置以了解自发性心房颤动的发生。使用双腔起搏器时，心室警告正常。确定阻抗以及检测和起搏阈值。确定心房有效不应期，近似于在爆破起搏期间保持一比一比率捕获的最短周期长度。通过测量起搏尖峰开始与右心房导联心房去极化之间的时间，确定左心房导联和右心房导联之间的传导时间。执行文本手稿中描述的三种方案。注意每个方案的心房颤动持续时间和心房颤动诱导性，然后让动物醒来或继续进行其他程序。随着时间的推移，观察到左心房导联的电压阈值和阻抗逐渐增加，表明纤维化增加。有害的起搏和50赫兹突发起搏协议比AERP加30毫秒起搏协议更成功。术后两周心房颤动诱导率开始增加，最高可达约25%，AERP加30毫秒方案效果最差，显示约10%心房颤动诱导率。有害的起搏和 50 赫兹爆发起搏使心房颤动诱导率提高到约 40%左心房起搏器的心房电图显示，在 5 秒 50 赫兹爆破起搏后，心房颤动诱导发作。而在这个中，没有AF诱导。与假体相比，Masson对左心房组织的三色染色显示无菌性心包炎动物的间质或血管旁纤维化水平更高。对蓝色纤维化组织面积相对于总心肌面积百分比的盲法定量表明，无菌性心包炎在心房组织中诱导的血管旁和间质纤维化比假手术更多。最重要的是获得具有足够电压阈值且无心室捕获的起搏器导线的良好定位。在初始手术后，很难纠正起搏器导联的问题，因为在此模型中观察到的广泛纤维化禁止更换导联。该协议侧重于外科和电生理学研究，但该模型也可用于组织学和心脏成像，包括CT和MRI。此外，与啮齿动物相比，更多的心房组织允许详细的转录组学和蛋白质组学研究。

Research

JoVE Journal

Medicine

High-Resolution Endocardial and Epicardial Optical Mapping in a Sheep Model of Stretch-Induced Atrial Fibrillation

高分辨率的心内膜和心外膜光学在拉伸诱发心房颤动的羊模型的映射

 Atrial fibrillation (AF) is a complex cardiac arrhythmia with high morbidity and mortality.1,2 It is the most common sustained cardiac rhythm disturbance ...

科研

医学

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

守望的左心耳封闭装置心房颤动

Atrial fibrillation (AF) is the most common cardiac arrhythmia, affecting an estimated 6 million people in the United States 1. Since AF affects primarily ...

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and  Ease of Implantation

心房遥感新的单一商会植入去纤颤器：一个实用的遥感示范和易于植入

Implantable cardioverter-defibrillators (ICDs) terminate ventricular tachycardia (VT) and ventricular fibrillation (VF) with high efficacy and can protect ...

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

结合消融房颤左心耳封堵

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, affecting millions of individuals worldwide 1-3. The rapid, irregular, and ...

Robotic Ablation of Atrial Fibrillation

房颤消融机器人

Background: Pulmonary vein isolation (PVI) is an established treatment for atrial fibrillation (AF). During PVI an electrical conduction block between ...

Isolation of Atrial Cardiomyocytes from a Rat Model of Metabolic Syndrome-related Heart Failure with Preserved Ejection Fraction

代谢综合征心力衰竭模型大鼠心房心肌细胞的分离与保留射血分数的关系

In this article, we describe an optimized, Langendorff-based procedure for the isolation of single-cell atrial cardiomyocytes (ACMs) from a rat model of ...

Left Atrial Stenosis Induced Pulmonary Venous Arterialization and Group 2 Pulmonary Hypertension in Rat

左心房狭窄致大鼠肺静脉动脉化及第2组肺动脉高压

The mechanism of mitral stenosis-induced pulmonary venous arterialization and group 2 pulmonary hypertension (PH) is unclear. There is no rodent model of ...

Isolation of Atrial Myocytes from Adult Mice

从成年小鼠分离心膜肌细胞

The electrophysiological properties of atrial myocytes importantly affect overall cardiac function. Alterations in the underlying ionic currents ...

Cooling or Warming the Esophagus to Reduce Esophageal Injury During Left Atrial Ablation in the Treatment of Atrial Fibrillation

在心房颤动治疗中，为食道冷却或加热，以减少左心房消融期间的食管损伤

Ablation of the left atrium using either radiofrequency (RF) or cryothermal energy is an effective treatment for atrial fibrillation (AF) and is the most ...

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

经导管闭合前心房通路的超声心动图评估

Transthoracic (TTE) and transesophageal echocardiography (TEE) is the standard imaging method for atrial septal defect (ASD) and patent foramen ovale ...