Carú B, Pedretti R, Bonelli R, Etro M D, Laporta A, Gementi A, Casucci R
Fondazione Clinica del Lavoro, Istituto di Ricovero e Cura a Carattere Scientifico, Centro Medico di Tradate, Italy.
Rev Port Cardiol. 1992 Oct;11(10):817-21.
In the present study we evaluated the influence of intravenous thrombolysis and patency of the infarct-related coronary artery on both markers of ventricular electrical instability and incidence of late arrhythmic events after acute myocardial infarction (AMI). Ninety one patients surviving a first AMI who consecutively performed coronary angiography were enrolled in the present study; 44 patients (48%) received thrombolysis, 47 patients (52%) were treated conventionally. Of 91 patients, 90 (99%) had signal-averaged electrocardiogram (SAECG), and 40 (44%) programmed ventricular stimulation. No significant difference was observed between thrombolytic-treated and control group in late potential rate, SAECG determinants and ventricular arrhythmia inducibility. Of 91 patients, 40 (44%) had occlusion of the infarct-related artery: of these, 15 (37%) had late potentials compared with 5 of 51 patients (9%) with a patent artery (p < 0.01). Mean left ventricular ejection fraction was not significantly different between the two groups (0.50 +/- 0.15 vs 0.55 +/- 0.12; p = NS). No significant difference was present between the two groups of patients with regard to inducibility of sustained ventricular tachyarrhythmias, however an odds ratio of 3.5 was observed in the group with a closed vessel.(ABSTRACT TRUNCATED AT 250 WORDS)
在本研究中，我们评估了静脉溶栓治疗以及梗死相关冠状动脉的通畅情况对急性心肌梗死（AMI）后心室电不稳定标志物和晚期心律失常事件发生率的影响。本研究纳入了91例首次发生AMI且连续接受冠状动脉造影的存活患者；44例患者（48%）接受了溶栓治疗，47例患者（52%）接受了传统治疗。91例患者中，90例（99%）进行了信号平均心电图（SAECG）检查，40例（44%）进行了程控心室刺激检查。溶栓治疗组与对照组在晚期电位发生率、SAECG指标和室性心律失常诱发性方面未观察到显著差异。91例患者中，40例（44%）梗死相关动脉闭塞：其中，15例（37%）有晚期电位，而动脉通畅的51例患者中有5例（9%）有晚期电位（p<0.01）。两组间平均左心室射血分数无显著差异（0.50±0.15对0.55±0.12；p=无显著性差异）。两组患者在持续性室性快速心律失常诱发性方面无显著差异，然而，在血管闭塞组观察到优势比为3.5。（摘要截断于250字）
