| ObjectiveThis article discusses the clinical value of the heart temporary pacemaker treatment of acute myocardial infarction(AMI). MethodsI selected 52 cases, in which all the patients were accurately diagnosed with acute myocardial infarction with chronic arrhythmia, and all patients agreed to accept direct percutaneous coronary intervention( percutaneous coronary intervention, PCI). I divided the cases into two groups: the group with patients who PCI preoperative installed temporary pacemaker as the intervention group and the group with patients who did not put in temporary pacemaker as the control group. Firstly, in order to filter the factors with statistic significance, I carried out an one-way analysis between the intervention group and the control group and compared the difference of perioperative blood flow dynamic change situation, PCI treatment effect, myocardial reperfusion injury and postoperative complications and short-term prognosis, etc between the two groups. Based on these analyses, I discussed the clinical application of the temporary pacemaker in acute myocardial infarction with chronic arrhythmia. Results1.Based on the clinical basic data comparison: there is no statistical significance on the difference in age, sex, coronary heart disease risk factors, infarction area, IRA, GRACE score between the two groups.2.26 patients in the intervention group were smoothly implanted into temporary pacemaker electrode, and atrial pace rate of the atrium dextrum is 100%. On average the time of the operation of the temporary pacemaker electrode was 9.5±2.5min, and thereserved time was 1 ~ 24 h. During the operation, two patients’ atrial paces were atrialpace, and their heart rate is about 40, and after that, permanent pacemakers were implanted. Besides, there is no puncture infection or any complications.3. After the PCI therapy, the systolic blood pressure and diastolic pressure of the patients in the intervention are higher than that of the control group. The temporary pacemaker has dramatically lowered the negative influence of coronary artery pressure on coronary blood flow.4.Based on the comparison of the PCI surgery effect: after interventional therapy,coronary artery blood flow of all of the patients of achieved TIMI Ⅱ ~ III level, and met the standard of recanalization. There was no statistically significant difference between the two groups in blood flow to IRA, TIMI grading; The rate above the myocardial perfusion grading TMP2 of the intervention group was higher than the control group(79.55% vs. 59.57%, P < 0.05).5.Based on the comparison of the situation of myocardial reperfusion injury:The incidence of reperfusion arrhythmia in the intervention group has obvious difference compared with the control group(9.92% vs. 56.20%, P < 0.05). There is statistically significant difference between the two groups in the incidence ofhypoglycemia(3.8%vs.19.2%,P<0.05). There are two patients in the intervention group had coronary slow flow phenomenon,and there is statistical significance between the two groups(7.7%vs.0%,P<0.05).6.After 6 months, in the follow-up visit, there were two patients died of myocardial infarction complicated heart failure, and none of such cases occurred in the intervention group. Compared with the control group, cardiogenic hospitalization rate of the intervention group is lower. Conclusion1.The temporary pacemaker is effective in the treatment of chronic arrhythmia, and it can effectively improve hemodynamics, and reduce the incidence of blood reperfusion injury and the complications, which further provide powerful guarantee for PCI;2.For recanalization, the intervention group delayed operation time 9.5 + 2.5 minutes on average, but there is no statistical significance;3.Compared with the control group, the intervention group improvedafter short-term prognosis, and the cardiogenic hospitalization rate obviously reduced. |
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