急性心肌梗死急诊PCI术中再灌注心律失常及防治

目的探讨急性心肌梗死患者急诊经皮冠状动脉介入术(PCI)中再灌注心律失常(RA)的特点及防治。方法127例急性心肌梗死患者行急诊经皮冠状动脉介入术,根据梗死相关动脉分为:左前降支组(LAD)33例、左回旋支(LCX)组11例、右冠状动脉(RCA)组32例,统计干预不同的冠状动脉中RA的发生情况。结果127例患者中76例发生心律失常,其中12例患者出现2种以上心律失常。LAD组发生快速心律失常多见,RCA组发生缓慢心律失常多见,部分患者需临时心脏起搏、直流电复律等。结论AM I患者急诊PCI术中常发生再灌注心律失常(RA)。RCA病变患者术中缓慢心律失常及严重心律失常多见,LAD病变患者快速心律失常多见。需熟练应用临时心脏起搏、直流电复律、利多卡因等防治RA。

Reperfusion arrhythmias in patients with acute myocardial infarction during direct percutaneous coronary interventions and its prevention and control

Objectives To investigate reperfusion arrhythmias in patients with acute myocardial infarction(AMI) during direct percutaneous coronary interventions(PCI) and its prevention and control.Methods 127 patients with AMI were undergone procedures of direct PCI.According to infract related arteries,they were divided into 3 groups(LAD,LCX and RCA groups).Calculate occurrence of RA in different coronary and its management.Results Among 127 patients with AMI,76 patients had occurred arrhythmias,and 12 patients had occurred more than 2 kinds of arrhythmias.Immediate cardiac arrhythmias were more occurred in patients with LAD procedures.But bradycardia arrhythmias were more occurred in patients with RCA procedures.Some of these patients needed temporary cardiac pacing,and electronic diversion,etc.Conclusion Reperfusion arrhythmias(RA) often occurred during direct PCI with AMI patients.Bradycardia arrhythmias occurred more in patients with RCA procedures.Immediate cardiac arrhythmias occurred more in patients with LAD procedures.We need well-trained application with temporary cardiac pacing,electronic diversion,lidocaine,etc.,to prevent and control RA.