Analysis of heart rate variability and clinical prognosis in patients with acute anterior myocardial infarction combined with complete right bundle branch block
Xu Zhi-yong,Kang Hong,Liu Lin-yong
Department of electrocardiogram, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou Fujian 363000, China
摘要 目的探讨急性前壁心肌梗死合并完全右束支传导阻滞(CRBBB)患者心率变异性(HRV)指标值变化，冠状动脉病变特点以及临床预后。方法选择新出现持续性CRBBB的急性前壁心肌梗死患者44例作为观察组，同期无束支传导阻滞的急性前壁心肌梗死患者225例作为对照组。两组患者均在发病1周内Holter监测一次，测HRV各指标值；比较两组发生恶性心律失常，冠脉病变及预后情况。结果观察组HRV各指标较对照组明显减低(P＜0.01)，观察组患者休克、心力衰竭、恶性心律失常的发生率明显高于对照组(P＜0.01)。冠状造影显示所有患者均存在前降支病变，观察组多支病变发生率显著高于对照组(82% vs 26%, P＜0.01)。结论急性前壁心肌梗死合并CRBBB患者HRV各指标值明显减低，心肌损伤面积大，冠脉病变弥漫，临床预后差。
Abstract：ObjectiveTo investigate the characteristics of heart rate variability (HRV) and clinical prognosis in patients with acute anterior myocardial infarction combined with complete right bundle branch block (CRBBB). MethodsA total of 44 cases with acute anterior myocardial infarction combined with CRBBB (observation group) and 225 cases of acute anterior myocardial infarction without CRBBB (control group) were enrolled in the study. Both two groups patients were underwent dynamic electrocardiogram (Holter) examination. HRV values and malignant arrhythmias, coronary disease and prognosis were compared between the two groups. ResultsCompared with control group, observation group had lower levels of HRV values,but higher incidence rates of shock, heart failure, malignant arrhythmia(P＜0.01). The results of coronary angiography showed that both two groups patients were present with left anterior descending artery lesions; and there were significant differences between observation group and control group with regard to the incidence rates (82% vs 26%, P＜0.01). ConclusionIn patients with acute anterior myocardial infarction with CRBBB, the levels of HRV value were low, the area of myocardial injury was large, and the clinical prognosis was worse.
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2013, Vol. 22 
