Một số yếu tố liên quan đến rối loạn nhịp tim ở bệnh nhân nhồi máu cơ tim cấp được can thiệp động mạch vành tại Bệnh viện Hữu nghị Việt Tiệp

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Tác giả: Mạnh Tân Vũ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Khoa học Sức khỏe, 2024

Mô tả vật lý: tr.1

Bộ sưu tập: Metadata

ID: 341906

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Mục tiêu: Nhận xét đặc điểm và một số yếu tố liên quan đến rối loạn nhịp tim ở bệnh nhân nhồi máu cơ tim cấp được can thiệp động mạch vành tại Bệnh viện Hữu nghị Việt Tiệp. Đối tượng và phương pháp nghiên cứu: nghiên cứu mô tả trên 93 bệnh nhân nhồi máu cơ tim cấp được can thiệp động mạch vành từ 7/2021 đến tháng 4/2022, ghi holter điện tim 24h trong vòng 24h đầu kể từ khi nhập viện, phân tích rối loạn nhịp và các yếu tố liên quan. Kết quả nghiên cứu: Tuổi trung bình: 70,12 ± 12,21, đa số ≥ 60 tuổi, nam (63,44%) nhiều hơn nữ (36,56%). 54,80% trường hợp sau nhồi máu cơ tim cấp có rối loạn nhịp tim. Tỷ lệ rối loạn nhịp thất chung 32,26%
ngoại tâm thu thất 30,11%. Tỷ lệ rối loạn nhịp trên thất 43,91%
rung nhĩ 15,05%. Chưa thấy liên quan giữa giới tính, loại nhồi máu, thời gian cửa bóng sau 6h và 12h với rối loạn nhịp tim (OR= 0,74
95%CI= 0,31-1,72
p= 0,62), (OR = 0,73
95%CI = 0,32-1,70
p= 0,61), (OR= 1,83
95%CI= 0,78-4,31
p= 0,24), (OR= 1,29
95%CI= 0,41-3,96
p= 0,66). Chưa thấy liên quan giữa vị trí nhồi máu thành trước và rối loạn nhịp thất (OR= 1,04
95%CI= 0,35-3,07
p= 0,99). Bệnh nhân NMCT cấp có phân số tống máu (EF%) ≤ 40% có nguy cơ gia tăng rối loạn nhịp thất so với bệnh nhân có phân số tống máu >
40% (OR=15,50
95%CI=1,77-135,59
p= 0,01). Kết luận: Ở bệnh nhân nhồi máu cơ tim cấp được can thiệp động mạch vành thủ phạm, ngoại tâm thu thất và rung nhĩ là các rối loạn thường gặp, phân số tống máu <
40% là yếu tố liên quan tới gia tăng rối loạn nhịp thất.Objectives: To review the characteristics and factors related to heart arrhythmias in patients with acute myocardial infarction (MI) who percutaneous coronary intervention (PCI) was performed at Viet Tiep Friendship Hospital. Subjects and research methods: descriptive study on 93 patients with acute MI who PCI was performed from July 2021 to April 2022, with 24h Holter monitor within 24 hours from admission time, analyzing arrhythmias and related factors. Results: The mean age was 70.12 ± 12.21 years old, major group was ≥ 60 years old, the rate of male (63.44%) was more than female (36,56%). There 54,80% of cases have arrhythmia after acute MI. Overall rate of ventricular arrhythmias was 32.26%
the rate of premature ventricular contractions was 30.11%. The rate of supraventricular arrhythmia was 43.91%
atrial fibrillation was 15.05%. No association was found between gender, blood type, 6 h and 12 h after door-to-balloon and arrhythmias (OR = 0.74
95% CI = 0.31-1.72
p = 0.62), (OR= 0.73
95% CI= 0.32-1.70
p= 0.61), (OR= 1.83
95% CI= 0.78-4.31
p= 0.24), (OR= 1.29
95% CI=0.41-3.96
p=0.66). No association was found between the infarction site of anterior ventricular wall and ventricular arrhythmias (OR= 1.04
95%CI= 0.35-3.07
p=0.99). Patients with acute MI and ejection fraction (EF%) ≤ 40% have an increased risk of ventricular arrhythmias compare to patients with EF% >
40% (OR= 15.50
95%CI= 1.77-135.59
p= 0.01). Conclusion: In patients with acute myocardial infarction who undergone intervention to culprit coronary artery, premature ventricular contractions and atrial fibrillation are most frequent, and EF% <
40% is a factor related to increased rate of ventricular arrhythmias. The relation of cardiac arrythmia with some risk factors in patients with cute myocardial infarction undergoing percutaneous coronary intervention at Viet Tiep Friendship Hospital.

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