"Stable" ventricular tachycardia is not a benign rhythm : insights from the antiarrhythmics versus implantable defibrillators (AVID) registry.
"Stable" ventricular tachycardia is not a benign rhythm : insights from the antiarrhythmics versus implantable defibrillators (AVID) registry.
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“稳定”室性心动过速不是良性节律：抗心律失常药与植入式除颤器 (AVID) 登记处的见解。
DOI：
10.1161/01.cir.103.2.244
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发表时间：
2001
期刊：
影响因子：
37.8
通讯作者：
AntiarrhythmicsVersusImplantableDefibrillatorsinvestigators
中科院分区：
文献类型：
--
作者：
Raitt,MH;Renfroe,EG;Epstein,AE;McAnulty,JH;Mounsey,P;Steinberg,JS;Lancaster,SE;Jadonath,RL;Hallstrom,AP;AntiarrhythmicsVersusImplantableDefibrillatorsinvestigators
背景：持续性室性心动过速（VT）可能不稳定，可能伴有严重症状，也可能稳定且相对无症状。不稳定VT的患者猝死的风险很高，最好使用植入式除颤器治疗。稳定性VT患者的预后存在争议，植入式心律转复除颤器治疗是否有益尚不清楚。方法和结果：抗心律失常与植入式除颤器（AVID）试验筛选了稳定型和不稳定型室性心动过速患者。两组患者均纳入登记，并记录其临床特征和出院治疗。死亡率数据通过国家死亡指数获得。440例稳定型室速患者的死亡率高于1029例不稳定型室速患者（3年时33.6% vs 27.6%；相对危险度[RR]=1.22；P=0.07）。调整基线和治疗差异后，RR变化不大（RR=1.25，P=0.06）。结论：无严重症状或血流动力学损害的持续室性心动过速与高死亡率相关，可能是基底物能够产生更恶性心律失常的标志。植入式心律转复除颤器治疗可能适用于表现为稳定VT的患者。
Background—Sustained ventricular tachycardia (VT) can be unstable, can be associated with serious symptoms, or can be stable and relatively free of symptoms. Patients with unstable VT are at high risk for sudden death and are best treated with an implantable defibrillator. The prognosis of patients with stable VT is controversial, and it is unknown whether implantable cardioverter-defibrillator therapy is beneficial.Methods and Results—Screening for the Antiarrhythmics Versus Implantable Defibrillators (AVID) trial identified patients with both stable and unstable VT. Both groups were included in a registry, and their clinical characteristics and discharge treatments were recorded. Mortality data were obtained through the National Death Index. The mortality in 440 patients with stable VT tended to be greater than that observed in 1029 patients presenting with unstable VT (33.6% versus 27.6% at 3 years; relative risk [RR]=1.22;P=0.07). After adjustment for baseline and treatment differences, the RR was little changed (RR=1.25,P=0.06).Conclusions—Sustained VT without serious symptoms or hemodynamic compromise is associated with a high mortality rate and may be a marker for a substrate capable of producing a more malignant arrhythmia. Implantable cardioverter-defibrillator therapy may be indicated in patients presenting with stable VT.