首页> 外文期刊>Japanese circulation journal >Thrombolytic therapy can reduce the arrhythmogenic substrate after acute myocardial infarction: a study using the signal-averaged electrocardiogram, endocardial catheter mapping and programmed ventricular stimulation.
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Thrombolytic therapy can reduce the arrhythmogenic substrate after acute myocardial infarction: a study using the signal-averaged electrocardiogram, endocardial catheter mapping and programmed ventricular stimulation.

机译:溶栓疗法可减少急性心肌梗死后的致心律失常底物:一项使用信号平均心电图,心内膜导管测绘和程序性心室刺激的研究。

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摘要

Thrombolytic therapy improves survival after acute myocardial infarction (AMI) primarily by preserving left ventricular function. Its influence on the arrhythmogenic substrate remains uncertain. To investigate the electrophysiologic effects of thrombolytic therapy, signal-averaged electrocardiography, endocardial catheter mapping and programmed stimulation were performed in 93 consecutive patients with their first AMI who underwent thrombolytic therapy. Early reperfusion was achieved in 75 patients (group 1), but not in 18 patients (group 2). The incidence of the signal-averaged electrocardiogram abnormality was 11% in group 1 (8 of 75 patients) and 33% in group 2 (6 of 18 patients) (p<0.02). Catheter mapping detected delayed endocardial electrograms in 30 group 1 patients and 10 group 2 patients (p=NS). The spatial distribution of these electrograms was smaller, and the longest duration of endocardial electrograms was shorter in group 1 than in group 2 (p<0.01). Sustained monomorphic ventricular tachycardia was induced less commonly in group 1 (20%) than in group 2 (44%) (p<0.05). In conclusion, thrombolytic therapy can reduce the arrhythmogenic substrate and improve electrical stability after AMI. This antiarrhythmic effect may contribute, in part, to the improved survival of patients treated with thrombolytic drugs.
机译:溶栓治疗主要通过保留左心室功能来改善急性心肌梗塞(AMI)后的生存。它对心律失常的基质的影响仍然不确定。为了研究溶栓治疗的电生理效果,对93例首例接受溶栓治疗的AMI患者进行了平均信号心电图,心内膜导管测绘和程序刺激。早期再灌注在75例患者(第1组)中实现,但在18例患者(第2组)中没有实现。第一组的平均信号心电图异常发生率为11%(75例中的8例),第二组的33%(18例中的6例)为33%(p <0.02)。导管测绘检测到30例1组患者和10例2组患者的心内膜电图延迟(p = NS)。这些电描记图的空间分布较小,并且心内电描记图的最长持续时间在第1组比第2组短(p <0.01)。维持单形性室性心动过速的发生率在第一组(20%)比第二组(44%)少(p <0.05)。总之,溶栓治疗可以减少心律失常的发生,并改善AMI后的电稳定性。这种抗心律不齐的作用可能部分有助于改善溶栓药物治疗患者的生存。

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