Sturm James T., Leachman Catherine J., Holub Daniel A., Norman John C.
Cardiovascular Surgical Research Laboratories of the Texas Heart Institute of St. Luke's Episcopal and Texas Children's Hospitals.
Cardiovasc Dis. 1980 Mar;7(1):83-89.
Early ventricular fibrillation occurs in approximately 5% of patients admitted for acute myocardial infarction. Although late ventricular fibrillation (> 48 hours postinfarction) may occur in stable patients, it occurs more commonly when severe left ventricular power failure is present. We have encountered late ventricular fibrillation in three of 42 (7%) patients treated with intraaortic balloon pumping (IABP) for profound cardiogenic shock secondary to myocardial infarction. These patients progressed to our hemodynamic Class A prior to weaning, and were thought to be stable prior to IABP removal. They were the only ones who expired after achieving Class A status. The episodes of late ventricular fibrillation occurred after the patients had been successfully weaned from IABP and were free of arrhythmias. This experience suggests that prolonged antiarrhythmic therapy may be indicated for postinfarction patients who have had ventricular dysrhythmias during IABP support.
急性心肌梗死入院患者中约5%会发生早期心室颤动。虽然晚期心室颤动（心肌梗死后>48小时）可能发生在病情稳定的患者中，但在出现严重左心室功能衰竭时更常见。我们在42例因心肌梗死继发严重心源性休克而接受主动脉内球囊反搏（IABP）治疗的患者中有3例（7%）发生了晚期心室颤动。这些患者在撤机前血流动力学状态进展为A级，且在移除IABP之前被认为病情稳定。他们是仅有的在达到A级状态后死亡的患者。晚期心室颤动发作发生在患者已成功撤离IABP且无心律失常之后。这一经验表明，对于在IABP支持期间发生室性心律失常的心肌梗死后患者，可能需要延长抗心律失常治疗。
