The use of ambulatory monitoring in the prognostic evaluation of patients with sustained ventricular tachycardia treated with amiodarone.
The use of ambulatory monitoring in the prognostic evaluation of patients with sustained ventricular tachycardia treated with amiodarone.
复制标题
动态监测在接受胺碘酮治疗的持续性室性心动过速患者的预后评估中的应用。
DOI：
10.1161/01.cir.74.5.1054
复制
发表时间：
1986
期刊：
影响因子：
37.8
通讯作者：
Reid,PR
中科院分区：
文献类型：
--
作者：
Veltri,EP;Griffith,LS;Platia,EV;Guarnieri,T;Reid,PR
我们最近报告了一项回顾性经验，连续霍尔特心电图监测作为指导治疗持续性室性心动过速患者胺碘酮治疗。为了证实和证实这些结果，设计了一项前瞻性研究，包括基线24小时霍尔特监测和胺碘酮治疗1周后的系列霍尔特监测。52例在基线霍尔特监测中表现为非持续性室性心动过速的记录持续性室性心动过速患者接受胺碘酮治疗。在治疗第8、9和10天进行的连续霍尔特监测中，34例患者（I组）的非持续性室性心动过速完全被抑制，18例患者（II组）的非持续性室性心动过速持续存在。在11.6 +/- 1.0（平均值+/- SE）个月随访时，3例（9%）I组患者和12例（67%）II组患者复发持续性室性心动过速或心源性猝死（p <0.01）。分析第8、9和10天24、48和72小时霍尔特监测预测复发性持续性室性心动过速或心源性猝死的敏感性、特异性、阳性和阴性预测值以及预测准确性。24、48和72小时霍尔特监测的阳性和阴性预测值分别为89%和84%、69%和89%、67%和91%。总体预测准确率分别为85%、83%和83%。我们的结论是，早期霍尔特监测有助于评估胺碘酮对基线霍尔特监测显示非持续性室性心动过速的持续性室性心动过速患者的临床疗效。
We recently reported a retrospective experience with serial Holter monitoring as a guide to therapy in patients with sustained ventricular tachycardia treated with amiodarone. To confirm and substantiate these findings, a prospective study was designed that included baseline 24 hr Holter monitoring and serial Holter monitoring after 1 week of therapy with amiodarone. Fifty-two patients with documented sustained ventricular tachycardia who manifest nonsustained ventricular tachycardia on baseline Holter monitoring were treated with amiodarone. Thirty-four patients (group I) had nonsustained ventricular tachycardia completely suppressed and 18 patients (group II) had continued nonsustained ventricular tachycardia on serial Holter monitoring performed on days 8, 9, and 10 of therapy. At 11.6 +/- 1.0 (mean +/- SE) months follow-up, three (9%) group I patients and 12 (67%) group II patients had recurrent sustained ventricular tachycardia or sudden cardiac death (p less than .01). The sensitivity, specificity, positive and negative predictive value, and predictive accuracy of ventricular tachycardia on 24, 48, and 72 hr Holter monitoring over days 8, 9, and 10 for predicting recurrent sustained ventricular tachycardia or sudden cardiac death were analyzed. The positive and negative predictive values were 89% and 84%, 69% and 89%, and 67% and 91% for 24, 48, and 72 hr Holter monitoring, respectively. Overall predictive accuracy was 85%, 83%, and 83%, respectively. We conclude that early Holter monitoring is useful in assessing the clinical efficacy of amiodarone in patients with sustained ventricular tachycardia who manifest nonsustained ventricular tachycardia on baseline Holter monitoring.