Bài giảng Rối loạn nhịp thất trong nhồi máu cơ tim cấp - ThS. Hoàng Việt Anh

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Bài giảng Rối loạn nhịp thất trong nhồi máu cơ tim cấp - ThS. Hoàng Việt Anh Hà Nội 26/11/2016 RỐI LOẠN NHỊP THẤT trong nhồi máu cơ tim cấp ThS.BS Hoàng Việt Anh Trưởng phòng Q3B - Viện Tim mạch quốc gia Việt Nam Nhồi máu cơ tim •  Là bệnh lý tim mạch có tỷ lệ mắc ngày càng tăng và tỷ lệ tử vong cao •  Tỷ lệ mới mắc tại Hoa Kỳ: 735.000 người/năm •  Yếu tố nguy cơ: Tăng huyết áp, ĐTĐ2, Rối loạn lipid máu, Béo phì, ít vận động thể chất, cuộc sống căng thẳng…. Rối loạn nhịp là một biến chứng của NMCT Reference to Ventricular MYOCAItDIAL to Ventricular % No. Episodes- 16 Dallas, 14 2 INTRODUCTION3 Tachycardia* mean E. with JONES, Total F.C.C,P,,** M.D., F. A. BASHOUR, Inferior Anterior Tachycardia* Reference LESION 10 SGOT of 213 units per ml, M.D.f M.D. true AND R. EDMONSON, tachycardia ventricular Texas per ml. In the absence of ventricular cardia, the accepted, mean because of the sequence SGOT rise generally the of coronary with of events following acute myocardial ligation infarction i Cardiac Arrhythmias in Acute Myocardial T Infarction M.D.f BASHOUR, M.D., F.C.C,P,,** Supraventricular E. JONES, infarction 5has changed AND ml. R. EDMONSO cardial tachycardia 4 1 16.6 per the past years; II. Incidence of the Common Arrhythmias block in0with 303 Specialremained 10 in the units The reported The number cardiac of patie 3 Complete AV incidence of arshock or heart failure on admission neighborhood of 30 cent. In the maMultifocal PVC’s 16 14 30 100 of instances, Reference to Ventricular Tachycardia* jority Texas death occurred in Voiume to demonstrate a close relationship Si, No. S Ectopic Dallas, ventricular first 48 50 per cent rhythms: clinical and of these patients, death is sudden and un- these May,myocardial 1967 features The developmentthe ofa infarction. a) True ventricular expected. These patients are clinically well of ectopic ventricular rhythms. Atrial F. A. fibrillation 1 HE MORTALITY RATE IN ACUTE MYO- arteries little in dogs, tricular it that this group and arrhythmia fibrillation. dies of ven- per rhythmias the hours. Approximately the F. A. olume ay, ine No. 51, INCIDENCE 1967 was or S used T atrial alone in arrhythmia. Cardiac wo groups myocardial one other T arrhythmias were OF BASHOUR, M.D., COMMON and patient one inferior into Texas myocardial infarction) bigeminy in the bigeminal INTRODUCTION one of these, R. JONES, Dallas, INTRODUCTION and ventricular divided E. F.C.C,P,,** ARRHYTHMIAS M.D.f tachycardia AND (rate than 523 greater than 100/mm) b) Slow ventricular rhythm (rate from 70-100/mm) 11 patients. In *One had generally patient accepted, rhythm lastedventricular rhythms. atEDMONSON, death the time of struction *From HE M.D. sufficient without myocardial tissue the 7 terminal 15 event, to 8 explain the Department at been University Southwestern Professor Medical generally f5* Present address 1 Medicine. of 6in intern - to widely. the 20 at this In group dies one, the run of by ventricular fibrillation. This frequency rhythm for cardiac Dilantin of the true patients continuous The fold: is recording with acute recording incidence and of the evaluation patients. arrhythmiaThe cardiac the the purpose are to of reportedthe describe of the that abnormal occur (Dila becau 3. beats were ventricular these bi the in the immediate post-infarction cardiac arrhythmias Stan- group variation of rhythmwas has used permitted prophylactically of the study consecutive of types the School. Medicine ford University. slow Resident in and Medicine. rapid ectopic Part of this work was presented at the Texas Heart Association Meeting, Texarkana (February 2, 1965) and the Midwestern Section, American Federation for Clinical Research, Chicago, November, l965.’ both cardiac methods de- necropsy 50 has It Medicine, of due hydantoin accepted, because of the sequence the of ligationeventscoronary followingin of agent of Texas **Associate HE MORTALITY three RATE hours. ventricular to MORTALITY the the location of RATEIN TrueACUTE MYO- tachycardia events following IN ACUTE of MYOthat was present in 15 patients, incianterior and inferior infarction ventricular in dogs, tachycardia. cardial has changed little and the arteries according infarction: of varied largely in this period. encountered study was in incidence Table of ous premature threeseri- the cardiac arrhythmia, ventricular presence of ventricular in to correlate tachycardia a preliminary of the disease, and the use of diphenyl- 13 patients known clinical three. of ven- and features report prematureon The the with ventricular associated arrhythmia andarteries in dogs, that thi past 30 years; in the cardialin the infarction it remained changed tricular little has MATERIAL TheThe reported glutamic incidence of ...