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早在1953年,Tennant和Wiggers发现心室颤动(VF)除由冠状动脉(简称冠脉)闭塞所致外,尚与冠脉的再灌注有关。直到1955年,Swell提出“再灌注心律失常”(reperfusion arrhythmias),人们才认识到心脏缺血时及缺血后再灌注时所产生的心律失常有着本质的不同。临床观察表明,50％变异性心绞痛病人ST段抬高恢复正常后有快速室性心律失常的发生。急性心肌梗塞(AMI)24小时内,尤其是4小时内发生VF的机会较多,而这些病人在VF发生前常主诉胸痛好转,这种现象可能与冠脉内血栓的自发溶解以及血管再通有关。动物实验发现,缺血心脏再灌注后VF的发生比冠脉闭塞时更为频繁。事实上,由冠脉内血栓形成引起AMI的患者,血栓溶解后所诱发的再灌注心律失常,以心室率70～95次/分的加速性室性自主心律最为常见,VF较为罕见。关
As early as 1953, Tennant and Wiggers found that ventricular fibrillation (VF) was related to coronary reperfusion in addition to the occlusion of coronary arteries (referred to as coronary arteries). It was not until 1955 that Swell put forth “reperfusion arrhythmias” that people realized that there was a fundamental difference in arrhythmias during and after ischemia and reperfusion. Clinical observations show that 50% of patients with variant angina ST-segment elevation after rapid ventricular arrhythmias occur. Acute myocardial infarction (AMI) within 24 hours, especially within 4 hours more chance of VF, and these patients often complained of chest pain in the VF before the turn of improvement, this phenomenon may be associated with spontaneous dissolution of coronary thrombosis and recanalization related. Animal experiments found that the occurrence of VF after ischemic reperfusion is more frequent than when coronary occlusion occurs. In fact, in patients with AMI caused by coronary thrombosis, reperfusion arrhythmias induced by thrombolysis are most common in patients with accelerated ventricular arrhythmia with a ventricular rate of 70-95 beats / min. VF is rare. turn off