Dobrotvorskaia T E, Mustafaev F M, Arifullin Sh S
Kardiologiia. 1989 Jan;29(1):44-8.
The results of repeated 24-hour ECG monitoring in 81 patients with documented transmural and macrofocal myocardial infarction are reported. The occurrence and pattern of heart rhythm disorders, including high-grade ventricular extrasystoles within the first day of the attack, were determined, as was the correlation between the infarction site and the occurrence of arrhythmia. The frequency and number of extrasystoles were the highest in recurrent myocardial infarction with developing left-ventricular insufficiency. High diagnostic value of 24-hour ECG monitoring, as compared to routine recordings, is demonstrated. The monitoring showed a significant drop in the frequency and number of extrasystoles by the end of the acute phase, including cases where no antiarrhythmic drugs were administered, and a significant rise in those in the subacute phase of myocardial infarction. It is suggested that the latter fact may be due to increased patient's physical activity in the course of convalescence, and myocardial autoimmune processes developing in the subacute phase.
报告了81例有透壁和大灶性心肌梗死记录患者的多次24小时心电图监测结果。确定了心律失常的发生情况和模式，包括发作第一天内的高级别室性期前收缩，以及梗死部位与心律失常发生之间的相关性。室性期前收缩的频率和数量在伴有进展性左心室功能不全的复发性心肌梗死中最高。与常规记录相比，显示出24小时心电图监测具有较高的诊断价值。监测显示，在急性期结束时，室性期前收缩的频率和数量显著下降，包括未使用抗心律失常药物的病例，而在心肌梗死亚急性期则显著上升。提示后一事实可能是由于患者在康复过程中体力活动增加，以及亚急性期发生的心肌自身免疫过程。
