摘要
目的 分析急性心肌梗死直接冠脉成形术后严重再灌注心律失常发生的状况 ,探讨其预防和紧急治疗方法。方法 行直接经皮冠状动脉成形术的急性心肌梗死患者 2 4 5例 ,根据梗死相关动脉分成三组 ,LAD组 :12 6例 ;RCA组 :97例 ;LCX组 :2 2例。统计各组经皮冠状动脉成形术后再灌注心律失常发生的状况。结果 共 15 1例患者发生严重的再灌注心律失常 ,发生率为 6 1 6 % ;加速性室性自主心律发生率最高 (2 2 0 % ) ,与梗死相关动脉无关 ;其次是室性早搏 (19 2 % ) ,以LAD组最高(2 7 8% )。RCA组缓慢性心律失常 (窦缓、窦性停搏、高度房室传导阻滞 )发生率 (35 1% )显著高于LAD组 (3 9% )和ICX组 (2 2 7% ) :LCX组各种再灌注心律失常发生率界于LAD组和RCA组之间。结论 急性心肌梗死直接冠脉成形术后严重心律失常总的发生率较高 。
Objective To analyse reperfusion arrythmia after primary coronary angioplasty in patients with acute myocardial infarction. Methods 245 patients with acute myocardial infarction was divided into 3 groups(LAD,RCA and LCX goup) according to infarct related artery. Results Reperfusion arrythmia after primary coronary anginoplasty occurred in 151(61 .6%) of 245 patients with acute myocardial infarction.Accelerated idioventricular rhythm was most frequent reperf usion arrhythmias(22.0%) with no difference among 3 groups. Ventricular premature developed in 35 (27.8%) of the 126 patients in LAD group. Sinus arrest and bradycardia or high degree AV block occurred in 37(38. 1%) of the 97 patients in RCA group. Most of deadly reperfusion arrhythmias (including sinusarrest,high degree AV block, parodoxysmal ventricular tacllycardia and ventricular fibrillation) occurred in RCA group. Conclusions Patients with acute myocardial infarction undertook primary coronary anginoplasty accompanied with a high incidence of reperfusion arrhythmias and the reperfusion arrhythmias occurrence was related to the infarct relative artery.
出处
《临床心电学杂志》
2003年第3期165-167,共3页
Journal of Clinical Electrocardiology
