ABSTRACT
Objective To explore the clinical characteristics of reperfusion arrhythmias (RA) in patients with ST segment el‐evation myocardial infarction(STEMI) after percutaneous coronary intervention (PCI) .Methods A total of 148 STEMI patients undergoing emergency PCI in our hospital from January 2010 to December 2014 were selected and divided into the RA group (71 cases) and non‐RA group (NRA group ,77 cases) according to whether RA occurring during PCI .The RA situation was observed . The relation between the infarct related artery and RA was analyzed ,the fall back situation of elevated ST segment was observed , the levels of cardiac troponin I (TnI) and creatine kinase isoenzyme MB (CK‐MB) and echocardiographic findings were compared between the two groups .Results The incidence rate of bradyarrhythmias in the left anterior descending coronary artery was signifi‐cantly lower than that in the right coronary artery and left circumflex artery ,while tachyarrhythmias in the left anterior descending coronary artery was higher than that in right coronary artery and left circumflex artery ,the differences were statistically significant (P<0 .05) .The opening time window and CK‐MB peak reaching time in the RA group were earlier than those in the NRA group , the fall amplitude of ST segment ,highest TnI and highest CK‐MB level in the RA group were higher tha those in the NRA group , the differences were statistically significant (P< 0 .05);among 48 cases of tachyarrhythmias ,tachyarrhythmia in 17 cases disap‐peared after intravenous drip or injection of lidocaine and which in 31 cases spontaneously disappeared without treatment ;among 23 cases of bradyarrhythmia ,bradyarrhythmia in 16 cases was controlled by intravenous injection of atropine ,which in 3 cases was con‐trolled within 1 week after placing temporary pacemaker and which in 4 cases was spontaneously disappeared without treatment . The incidence rate of main adverse events in the RA group was 2 .8% ,which was lower than 11 .7% in the NRA group ,the left ventricular ejection fraction in the RA group was significantly higher than that in the NRA group ,the end diastolic diameter and end systolic diameter of the left ventricle were significantly lower than those in the NRA group ,and the differences were statistically significant (P<0 .05) .Conclusion The incidence of RA in the patients with STEMI is higher ,which needs to adopt various effec‐tive methods to actively treat .
ABSTRACT
BACKGROUND:Studies addressing coronary heart disease are largely dependent on the establishment of myocardial infarction animal models. It is very important that exploring a safe method with easy operation, less damage, long time survival and high survival rate for myocardial infarction animal model OBJECTIVE:To compare the pros and cons of two kinds of thoracotomy anterior descending coronary artery ligation to do myocardial infarction animal model. METHODS: Thirty healthy male New Zealand white rabbits were randomly divided into three groups: control, median sternotomy incision, and left sternal incision. The anterior descending coronary artery was ligated after thoracotomy. The operation time, amount of intraoperative bleeding, postoperative food intake, and recovery time of eating were monitored during the surgery and within 24 hours after the surgery. And myocardial enzyme indexes were also monitored within 24 hours after the surgery. Rabbits were detected with ultrasonic echocardiogram at 4 weeks. RESULTS AND CONCLUSION:Different levels of ST segment elevation appeared in median sternotomy and left sternal incision groups by echocardiogram. The success rate of modeling was 70% in median sternotomy incision group, and 80% in left sternal incision group. Within 24 hours post-surgery, the myocardial enzyme indexes in the two groups were significantly increased compared with before surgery (P < 0.05). At 4 weeks, the left ventricular ejection fraction and the left ventricular shortening fraction were significantly decreased when compared to before surgery (P< 0.05). The operation time was shorter, the amount of bleeding was less, the time of eating recovery was less and the amount of eating was much in median sternotomy group than in left sternal incision, with significant differences between he two groups (P < 0.05). The median sternotomy incision for the ligation of anterior descending coronary artery is better than the left sternal incision to establish myocardial infarction models.