CAJ | 학술논문

目的：探讨起搏器患者合并心肌梗死心电图的诊断方法。方法对12例不同类型起搏合并不同分期心肌梗死患者的心电图进行分析研究。结果置入起搏器后，当自身心室下传时，不同分期心肌梗死的心电图特征不会被掩盖；而心室起搏时，心肌梗死分期的Q波、ST-T改变部分可被掩盖，有时不易辨认，这主要取决于置入起搏器的类型、工作模式、电极置入的部位及心肌梗死的部位、分期等诸多因素。结论心脏起搏器置入患者合并心肌梗死的心电图有一定的特殊性，在诊断分析时，必须密切结合临床，动态观察心电图变化，必要时改变起搏方式，以保证诊断的正确性。
목적：탐토기박기환자합병심기경사심전도적진단방법。방법대12례불동류형기박합병불동분기심기경사환자적심전도진행분석연구。결과치입기박기후，당자신심실하전시，불동분기심기경사적심전도특정불회피엄개；이심실기박시，심기경사분기적Q파、ST-T개변부분가피엄개，유시불역변인，저주요취결우치입기박기적류형、공작모식、전겁치입적부위급심기경사적부위、분기등제다인소。결론심장기박기치입환자합병심기경사적심전도유일정적특수성，재진단분석시，필수밀절결합림상，동태관찰심전도변화，필요시개변기박방식，이보증진단적정학성。
Objective To explore the diagnostic method of myocardial infarction in the patient with im-planted permanent pacemaker by ECG .Methods ECGs of 12 patients with different pacemaker types and different phases of myocardial infarction were analyzed .Results After implanting pacemaker ,when ventricular depolariza-tion was conducted intrinsically ,the characteristics of ECG of different phases of myocardial infarction were not cov-ered,but during ventricular being paced Q wave and ST-T changes of ECG in different phases of myocardial infarc-tion were covered partly .It could not be sometimes distinguished easily .This was mainly determined by the type of pacemaker,working mode,the position of implanted pacing electrode ,the position and phase of myocardial infarc-tion,and so on.Conclusions The ECG of myocardial infarction in the patient with implanted permanent pacemak-er had some specific characteristics .For ensuring diagnosis ,ECG must be combined with clinical manifestation ,and the changes of ECG should be observed carefully as well as the mode of cardiac pacing should be changed in case of need.