Doshchitsin V L, Merkulova I N
Kardiologiia. 1976 Jul;16(7):19-25.
Ventricular fibrillation and asystole are a frequent cause of death in myocardial infarction. The data of continuous monitoring the heart in 134 patients with acute myocardial infarction and ventricular fibrillation and asystole. The immediate precursors of ventricular fibrillation were predominantly ventricular extrasystoles. A frequent precursor of ventricular fibrillation consists in paroxysmal ventricular tachycardia. In some patients the ventricular fibrillation was preceded by the block of the bundle of His, non-paroxysmal ventricular tathycardia, escaping contractions and some other arrhythmias. A factor providing for the development of ventricular fibrillation consists in the Q-T interval lengthening on ECG. Ventricular asystole is usually preceeded by atrioventricular block, Stage II-III, and the block of the bundle of His, as well as by ventricular tachycardia and extrasystole, in some cases--by sinus bradycardia and sinoauricular block (weakness of the sinus node). The examination of the rhythm and conductivity disorders preceeding the ventricular fibrillation is of great importance in view of the possibilities of prevention of "arrhythmic death".
心室颤动和心搏停止是心肌梗死常见的死亡原因。对134例急性心肌梗死合并心室颤动和心搏停止患者的心脏进行连续监测的数据。心室颤动的直接先兆主要是室性期前收缩。心室颤动常见的先兆是阵发性室性心动过速。在一些患者中,心室颤动之前有希氏束传导阻滞、非阵发性室性心动过速、逸搏收缩及其他一些心律失常。心电图上Q-T间期延长是导致心室颤动发生的一个因素。心搏停止通常之前有Ⅱ-Ⅲ度房室传导阻滞、希氏束传导阻滞,以及室性心动过速和期前收缩,在某些情况下还有窦性心动过缓和窦房阻滞(窦房结功能减弱)。鉴于预防“心律失常性死亡”的可能性,对心室颤动之前的节律和传导障碍进行检查非常重要。