Electrode-Catheter Arrhythmia Induction in the Selection and Assessment of Antiarrhythmic Drug Therapy for Recurrent Ventricular Tachycardia
Electrode-Catheter Arrhythmia Induction in the Selection and Assessment of Antiarrhythmic Drug Therapy for Recurrent Ventricular Tachycardia
复制标题
电极导管心律失常诱导在复发性室性心动过速抗心律失常药物治疗选择和评估中的应用
作者：
J. Mason;R. Winkle
我们对33例反复发作的室性心动过速患者进行了心内电生理检查。19例患者接受了1次、10例患者接受了2次和4例患者接受了3次连续电生理研究。83%的患者成功诱导室性心动过速，71%的研究中起搏方法成功终止心动过速，尽管36%的研究中起搏诱导的室性心动过速加速至少发生一次。33例患者中有17例（52%）在研究期间共需要24次外部直流电复律，其中21例患者静脉注射各种抗心律失常药物，并重复尝试室性心动过速诱导，以评估药物的预防效果。在15名患者（71%）中发现了急性有效的药物或药物组合。15名患者中有14名接受了有效药物的长期口服治疗，平均随访时间为8.1个月（范围1至33个月）。在所有14例患者中，我们可以记录完整的（13例）或部分（1例）长期预防室性心动过速。我们的结论是，药物疗效试验在复发性室性心动过速患者使用心内起搏技术是一种快速，准确的方法，选择有效的长期抗心律失常治疗。
SUMMARY We performed intracardiac electrophysiologic studies in 33 patients with recurrent ventricular tachycardia. Nineteen patients underwent one, 10 patients two, and four patients three serial electrophysiologic studies. Ventricular tachycardia was successfully induced in 83% of the patients, and pacing methods were successful in terminating tachycardia in 71% of the studies, although pacing-induced acceleration of ventricular tachycardia occurred at least once in 36% of the studies. Seventeen of the 33 patients (52%) required a total of 24 external direct current cardioversions during study.In 21 patients a variety of antiarrhythmic drugs were given I.V. and attempts at ventricular tachycardia induction were repeated to assess prophylactic effects of the drugs. An acutely effective drug or combination of drugs was found in 15 of the patients (71%). Fourteen of the 15 were placed on chronic oral therapy with the effective agent and were followed for an average period of 8.1 months (range one to 33 months). In all 14 patients we could document complete (13 patients) or partial (one patient) long-term prophylaxis against ventricular tachycardia.We conclude that drug efficacy trials in patients with recurrent ventricular tachycardia using intracardiac pacing techniques is a rapid and accurate method of selecting effective long-term antiarrhythmic therapy.