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本文对我院1974～1984年1197例急性心肌梗塞中合并室上性心律失常的262例进行分析,并对心律失常类型、原因及预后进行了讨论。本组室上性心律失常包括房性早搏、交界性早搏、阵发性室上性心动过速、心房扑动和颤动。总发生率为21.8%。结果显示室上性心律失常的发生主要与心功能不全有关,与梗塞部位、窦房结动脉供血、是否累及心包和心房损伤无明确关系。急性心肌梗塞合并室上性心律失常的病死率与同期心肌梗塞的平均死亡率相比无明显差异,但当快速室上性心律失常,特别是房颤和阵发性室上性心动过速继发于心功能不全时,常使心功能进一步恶化,病死率明显增高。建议积极使用地高辛或电击复律,迅速扭转异位心律,改善心功能,或可减低由此引起的病死率。
In this paper, our hospital from 1974 to 1984, 1197 cases of acute myocardial infarction in 262 cases with supraventricular arrhythmia were analyzed and arrhythmia types, causes and prognosis were discussed. This group of supraventricular arrhythmias include atrial premature beats, borderline premature beats, paroxysmal supraventricular tachycardia, atrial flutter and fibrillation. The total incidence was 21.8%. The results showed that the occurrence of supraventricular arrhythmias mainly related to cardiac insufficiency, and infarction, sinus node artery blood supply, whether the involvement of pericardial and atrial injury is not clear relationship. Acute myocardial infarction combined with supraventricular arrhythmia mortality and myocardial infarction over the same period, the average mortality rate was no significant difference, but when the rapid supraventricular arrhythmias, in particular, atrial fibrillation and paroxysmal supraventricular tachycardia following Fat in heart failure, often worsened cardiac function, mortality was significantly higher. It is recommended to actively use digoxin or shock cardioversion, rapid reversal of ectopic heart rhythm, improve cardiac function, or reduce the resulting mortality.