摘要
目的:观察无导线起搏器联合经皮冠状动脉介入(PCI)术治疗急性心肌梗死(AMI)合并心律失常的疗效及对心电图参数、不良心血管事件的影响。方法:选取2020年6月—2021年6月我院收治的接受无导线起搏器联合PCI术治疗的80例AMI合并心律失常病人,统计无导线起搏器置入情况、PCI术手术效果、心功能、心肌灌注分级、起搏器电学参数、心电图参数、再灌注损伤与不良心血管事件。结果:介入治疗后全部病人均符合冠状动脉再通标准。80例均成功置入MicraTM无导线起搏器,起搏成功率为100%。治疗后左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、阈值、阻抗、QT间期均小于治疗前(P<0.05);左室射血分数(LVEF)、心排血量(CO)、感知、PR间期、QRS间期均大于治疗前(P<0.05);心肌组织灌注(TIMI)分级情况均优于治疗前(P<0.05),TIMI分级Ⅱ级以上的比例82.50%。80例中16例发生再灌注损伤,但无因再灌注损伤发生死亡者。随访6个月18例发生不良心血管事件。结论:无导线起搏器联合PCI术可改善AMI合并心律失常病人的心功能、心肌灌注分级、起搏器电学参数、心电图参数,冠状动脉再通率高、起搏成功率高,但可能发生再灌注损伤与不良心血管事件。
Objective:To observe the efficacy of wireless pacemaker combined with percutaneous coronary intervention(PCI)for the treatment of acute myocardial infarction(AMI)with arrhythmia and its impacts on electrocardiogram and adverse cardiovascular events.Methods:A total of 80 patients with AMI complicated with arrhythmia who were treated with wireless pacemaker combined with PCI were selected.The implantation status of wireless pacemakers,the effectiveness of PCI surgery,cardiac function,myocardial perfusion grading,pacemaker electrical parameters,electrocardiogram,reperfusion injury,and adverse cardiovascular events were analyzed.Results:All patients met the criteria of coronary artery recanalization with interventional therapy.There were 80 cases,with MicraTM wireless pacemakers successfully implanted,and the pacing success rate was 100%.After treatment,left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),threshold value,impedance,and QT interval were all lower than that before treatment(P<0.05).Left ventricular ejection fraction(LVEF),cardiac output(CO),perception,PR interval,and QRS interval were all higher than that before treatment(P<0.05).Thrombolysis in myocardial infarction(TIMI)grading was better than that before treatment(P<0.05).The proportion of TIMI gradeⅡor above was 82.50%.Reperfusion injury occurred in 16 of the 80 patients,but there was no death due to reperfusion injury.After 6 months of follow-up,18 patients had adverse cardiovascular events.Conclusion:The combination of wireless pacemaker and PCI can improve cardiac function,myocardial perfusion grading,pacemaker electrical parameters,electrocardiogram parameters in patients with AMI combined with arrhythmia,and with high coronary artery patency rate and high pacing success rate.However,reperfusion injury and adverse cardiovascular events may occur.
作者
王晓丽
王侠
韩淑洁
罗盛明
WANG Xiaoli;WANG Xia;HAN Shujie;LUO Shengming(Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120,Guangdong,China)
出处
《中西医结合心脑血管病杂志》
2024年第17期3100-3103,共4页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
基金
2022年度广东省中医药局科研项目(No.20221192)。
关键词
急性心肌梗死
心律失常
无导线起搏器
经皮冠状动脉介入治疗
心电图
不良心血管事件
acute myocardial infarction
arrhythmia
wireless pacemaker
percutaneous coronary intervention
electrocardiogram
adverse cardiovascular events
作者简介
通讯作者:王侠,E-mail:chenrkgd@126.com。
