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急性心肌梗死的主要危险之一为心律失常,及早发现与治疗是降低病死率的重要措施。急性心肌梗死伴有心动过缓者的药物治疗有其局限性。异丙基肾上腺素仅适用于急性心脏停搏和威胁性心动过缓使用起搏器前的过渡。阿托品对窦房性心动过缓和房室区域近侧部份的传导阻滞有疗效。但作用短暂,应密切观察;一旦发现阿托品不能提高心室率,尤其是合并心衰和异位性心律失常时应考虑使用临时性起搏器。后壁梗死伴房室传导阻滞者,如果代偿性节律稳定,率够快,小QRS复合波,无心衰和异位性心律失常者,有时甚至不需使用起搏器。前壁梗死伴房室传导阻滞是使用起搏器的强烈指征。Ⅰ度房室传导阻滞Ⅰ型试用阿托品。如果不能提高心室率,或属于Ⅱ型或Ⅱ度房室传导阻滞合并单侧束枝传导阻滞,应使
One of the major risks of acute myocardial infarction is arrhythmia, and early detection and treatment are important measures to reduce mortality. Acute myocardial infarction with bradycardia drug treatment has its limitations. Isoproterenol is only suitable for transition from pre-pacer to acute cardiac arrest and threatened bradycardia. Atropine on the sinoatrial bradycardia and proximal atrioventricular block block effect. But the role of short-term, should be closely observed; once found atropine can not improve ventricular rate, especially in combination with heart failure and atopic arrhythmias should consider the use of temporary pacemaker. Posterior wall infarction with atrioventricular block, if compensatory rhythm stable, fast enough, small QRS complex, no heart failure and atopic arrhythmias, and sometimes do not even need to use pacemakers. Anterior wall infarction with atrioventricular block is a strong indication of the use of a pacemaker. Ⅰ degree atrioventricular block Ⅰ trial of atropine. If you can not improve the ventricular rate, or Ⅱ or Ⅱ degree atrioventricular block associated with unilateral bundle branch block should be made