急性心肌梗塞并发心脏传导阻滞88例临床特点

The clinical characteristics of heart block in acute myocardial infarction

分析了88例急性心肌梗塞(AMI)并发心脏传导阻滞的临床经过,显示AMI并发束支传导阻滞发生率为14.15%,并发房室传导阻滞(AVB)发生率为12.22%;其阻滞类型与梗塞部位有关;AVB经过多短暂,束支传导阻滞多不易恢复;对于AVB的治疗,一般不主张起搏治疗。

The incidence of various conduction disturbances in acute inferior myocardial infarction issignificantly different from that in anterior myocardial infarction. Atrioventricular block (AVB) ininferior wall infarctions seems five times more frequently than that in anterior wall infarctions, becausethe blood supply to the AV node is compromised by the obstruction of the right coronary artery,fromwhich the AV node artery arises in 90% of the cases. Fascicular block in anterior wall infarctionsseems twelve times more frequently than that in inferior wall infarctions, because the proxismal bundlebranch is supplied by left anterior descending coronary artery. Fascicular block was observed in14. 15% of the patients with AMI admitted to the CCU. AVB occurred in approximately 12. 22% ofAMI patients. In patients with inferior wall infarction, return to normal AV conduction is the rule.Fascicular block usually does not return to normal conduction. It is generally believed that AVBneedn't be treated with transplanting pacemaker.