【缺血性心脏病患者心律失常及手术治疗指征】。

Grudnaia khirurgiia (Moscow, Russia) Pub Date : 1989-07-01
L A Bokeriia, E B Fitileva
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引用次数: 0

摘要

作者分析了171例缺血性心脏病(IHD)和危及生命和非威胁性心律失常患者手术治疗前后的情况。对照组由34例IHD患者(与主要疾病的严重程度相似)组成,但无心律失常。第三心律失常组的危及生命的心律失常即使在有效的心肌血运重建和切除动脉瘤后仍持续存在。为了揭示这组患者的选择性不稳定区,术前电生理检查必须在有计划的心脏刺激下进行,以便随后同时纠正冠状动脉循环和心脏传导系统。不能手术的IHD患者伴有威胁性心律失常(根据冠状动脉病理),在内脏部分无禁忌症的情况下,被认为是心脏移植的潜在接受者。IHD和非威胁性心律失常患者应继续观察并给予纠正药物治疗。关于手术治疗的问题是根据IHD的标准适应症来决定的。
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[Arrhythmia in patients with ischemic heart disease and indications for surgical treatment].

The authors analysed 171 patients with ischemic heart disease (IHD) and life-threatening and non-threatening arrhythmias before and after surgical treatment. The control group was composed of 34 patients with IHD (of a similar severity of the principle disease) but without arrhythmias. Life-threatening arrhythmias of the third arrhythmic group persisted even after effective revascularization of the myocardium and resection of the aneurysm. To reveal the zones of elective instability in this group of patients preoperative electrophysiological examination must be conducted with programmed stimulation of the heart for subsequent simultaneous correction of coronary circulation and the conducting system of the heart. Inoperable patients suffering from IHD with threatening arrhythmias (according to coronary pathology) are considered, in the absence of contraindications on the part of the viscera, to be potential recipients for heart transplantation. Patients with IHD and non-threatening arrhythmias should be kept under observation and given corrective drug therapy. The question concerning their operative treatment is decided upon according to the standard indications for IHD.

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