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[心肌梗死中的晚期心律失常]

[Late arrhythmias in myocardial infarct].

作者信息

Zhivoderov V M, Doshchitsin V L, Dunaeva Z I, Kolomeĭtseva S P, Nazarova V I

出版信息

Kardiologiia. 1980 Jan;20(1):22-5.

PMID:7354588
Abstract

The authors had 75 patients with myocardial infarction under observation. After the 15th day of the disease various disorders of cardiac rhythm and conductivity were revealed in 85% of patients during cardiomonitor surveillance. The most frequent occurrences were ventricular extrasystole (72.5%), sinus bradycardia (40%) and atrial extrasystole (37.5%). Primary ventricular fibrillation was noted in 4 (5.3%) patients two of whom were resuscitated. In 50 patients with myocardial infarction of more than one month duration disorders of cardiac rhythm during physical load were studied (dosed walking under telectrocardiographic control and/or on a treadmill). During dosed waling 28% of patients developed arrhythmia or it was intensified (sinus tachycardia was not taken into account). During a load on a treadmill such changes were encountered in 30% of patients. A favourable effect of treatment with cordarone was produced in most patients with ventricular extrasystole some of whom were resistant to lidocain treatment. A good effect was produced in some patients by means of the pulsnorma or rythmodan. Beta-adrenergic blocking agents as well as cordaron and isoptin were effective in atrial extrasystole and sinus tachycardia. Hyperbaric oxygenation was used in 14 patients with disorders of rhythm. Disappearance of arrhythmia or considerable improvement was registered in 11 patients after treatment consisting of 10-12 procedures.

摘要

作者对75例心肌梗死患者进行了观察。在疾病第15天之后,通过心脏监测发现85%的患者出现了各种心律失常和传导障碍。最常见的是室性早搏(72.5%)、窦性心动过缓(40%)和房性早搏(37.5%)。4例(5.3%)患者出现原发性心室颤动,其中2例经复苏成功。对50例病程超过1个月的心肌梗死患者,研究了其体力负荷时的心律失常情况(在心电图监测下和/或在跑步机上进行定量步行)。在定量步行过程中,28%的患者出现心律失常或心律失常加重(窦性心动过速未计入)。在跑步机负荷时,30%的患者出现此类变化。多数室性早搏患者使用胺碘酮治疗效果良好,其中一些患者对利多卡因治疗耐药。一些患者使用普罗帕酮或乙吗噻嗪效果良好。β-肾上腺素能阻滞剂以及胺碘酮和维拉帕米对房性早搏和窦性心动过速有效。14例心律失常患者接受了高压氧治疗。经过10 - 12次治疗后,11例患者的心律失常消失或有显著改善。

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