Piszczek I, Ochotny R, Poprawski K
I Kliniki Kardiologii Instytutu Kardiologii AM, Poznaniu.
Kardiol Pol. 1992;36(2):74-9.
Our studies were aimed at evaluating the prognostic value of certain clinical and echocardiographic parameters as well as cardiac arrhythmias in patients with acute myocardial infarction complicated by ventricular fibrillation. The studies comprised 66 patients with previous ventricular fibrillation selected out of 637 patients undergoing treatment after recent myocardial infarction at the Clinic of Cardiology, Institute of Cardiology, Medical Academy, Poznań. The group included 51 males and 15 females aged 30-83, mean age 68. Anterior and/or lateral infarction were diagnosed in 44 patients (67%) whereas inferior and/or posterior infarction in 22 patients (33%). Fifty-eight patients (88%) had transmural infarction. The 2D and M-mode echocardiographic examinations and 24-hour Holter monitoring were performed in all patients. The group of patients resuscitated successfully was compared to the group of deceased patients. The observation period ranged from 1 to 7 years, mean 4 years. The analysis indicated that high mortality of patients with late ventricular fibrillation results from an extensive myocardial infarction and severe ventricular contractility disorders. In patients with late ventricular fibrillation, the main prognostic factor proves to be congestive heart failure and intraventricular conduction disorders with the fascicular and/or bundle-branch block types.
我们的研究旨在评估某些临床和超声心动图参数以及心律失常对急性心肌梗死合并心室颤动患者的预后价值。这些研究纳入了66例既往有过心室颤动的患者，他们是从波兹南医科大学心脏病学研究所心脏病科近期心肌梗死后接受治疗的637例患者中挑选出来的。该组包括51名男性和15名女性，年龄在30 - 83岁之间，平均年龄68岁。44例患者（67%）诊断为前壁和/或侧壁梗死，而22例患者（33%）诊断为下壁和/或后壁梗死。58例患者（88%）为透壁性梗死。所有患者均进行了二维和M型超声心动图检查以及24小时动态心电图监测。将成功复苏的患者组与死亡患者组进行比较。观察期为1至7年，平均4年。分析表明，晚期心室颤动患者的高死亡率是由广泛的心肌梗死和严重的心室收缩功能障碍所致。在晚期心室颤动患者中，主要的预后因素被证明是充血性心力衰竭和室内传导障碍，表现为分支和/或束支阻滞类型。
