Spontaneous arrhythmia detected on ambulatory electrocardiographic recording lacks precision in predicting inducibility of ventricular tachycardia during electrophysiologic study.
Spontaneous arrhythmia detected on ambulatory electrocardiographic recording lacks precision in predicting inducibility of ventricular tachycardia during electrophysiologic study.
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动态心电图记录检测到的自发性心律失常在预测电生理学研究期间室性心动过速的诱发性方面缺乏准确性。
DOI：
10.1016/s0735-1097(87)80166-3
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发表时间：
1987
影响因子：
24
通讯作者：
Wyndham,CR
中科院分区：
文献类型：
--
作者：
Pratt,CM;Thornton,BC;Magro,SA;Wyndham,CR
本研究探讨动态心电图（ECG）监测的自发性室性心律失常与程序性电刺激诱发室性心动过速的关系。80例患者（男性65例，女性15例），平均年龄58岁，出现以下症状之一：持续性室性心动过速（n = 54）；需要复苏的猝死（n = 4）；心室颤动（n = 11）；或被认为是心源性晕厥（n = 11）。所有患者均在未接受抗心律失常治疗的情况下进行24小时动态心电图和程控电刺激。程序电刺激导致80例患者中53例诱发性持续性室性心动过速（定义为≥120次/分持续≥1分钟或需要干预）。在动态心电图上没有检测到自发性心律失常的频率或复杂性，可以识别程序电刺激期间继发性室性心动过速的诱发程度。事实上，25%的诱发性持续性室性心动过速患者在动态心电图上很少或没有自发性心律失常。此外，在53例可诱导持续性室性心动过速患者中，28%和55%的患者在动态监测期间分别没有偶联或非持续性室性心动过速。持续性室性心动过速的临床表现、确诊的冠状动脉疾病和左心室射血分数<30%相结合，在预测持续性室性心动过速的诱导性方面比任何动态心电图标准都有更好的阳性预测值。
This study investigates the relation of spontaneous ventricular arrhythmia on ambulatory electrocardiographic (ECG) monitoring to the subsequent inducibility of ventricular tachycardia during programmed electrical stimulation. Eighty patients (65 men, 15 women), whose mean age was 58 years, presented with one of the following: sustained ventricular tachycardia (n = 54); sudden death requiring resuscitation (n = 4); ventricular fibrillation (n = 11); or syncope thought to be of cardiac origin (n = 11). All patients had 24 hour ambulatory electrocardiograms and programmed electrical stimulation while receiving no antiarrhythmic therapy. Programmed electrical stimulation resulted in inducible sustained ventricular tachycardia (defined as a rate of ≥120 beats/min for ≥1 minute or requiring intervention) in 53 of the 80 patients.There was no measure of frequency or complexity of spontaneous arrhythmia detected on ambulatory ECG that could identify the degree of subsequent ventricular tachycardia inducibility during programmed electrical stimulation. In fact, 25% of patients who had inducible sustained ventricular tachycardia had little or no spontaneous arrhythmia on ambulatory ECG. Furthermore, of the 53 patients with inducible sustained ventricular tachycardia, 28 and 55% had no couplets or nonsustained ventricular tachycardia, respectively, during ambulatory monitoring.The combination of a clinical presentation of sustained ventricular tachycardia, confirmed coronary artery disease and a left ventricular ejection fraction of <30% had a better positive predictive value than did any ambulatory ECG criterion in predicting the inducibility of sustained ventricular tachycardia.