Coronary artery revascularization in patients with sustained ventricular arrhythmias in the chronic phase of a myocardial infarction: Effects on the electrophysiologic substrate and outcome
Coronary artery revascularization in patients with sustained ventricular arrhythmias in the chronic phase of a myocardial infarction: Effects on the electrophysiologic substrate and outcome
复制标题
DOI：
10.1016/s0735-1097(00)01133-5
复制
发表时间：
2001-02-01
影响因子：
24
通讯作者：
Sanz, G
中科院分区：
文献类型：
--
作者：
Brugada, J;Aguinaga, L;Sanz, G
本研究的目的是分析冠状动脉血运重建术对室性心律失常患者的影响。然而，其对与急性缺血事件无关的室性心律失常的影响尚未仔细研究。前瞻性研究了58名男性患者，平均年龄65 ± 8岁，既往患有心肌梗死、与急性缺血事件无关的自发性室性心律失常（55例室性心动过速，9例室颤）和需要血运重建的冠状动脉病变。结果61例患者在首次研究中诱发持续性室性心律失常。血运重建后，在62名存活者中，59名先前可诱导的患者中有52名仍然可诱导（A组），10名患者不可诱导（B组）。两组之间的临床、血流动力学、治疗和电生理特征无差异。在32 +/- 26个月随访期间，A组52例患者中有28例（54%）和B组10例患者中有4例（40%）发生了腹泻事件（p = 0.46）。射血分数
OBJECTIVES The objective of this study was to analyze the influence of coronary artery revascularization in patients with ventricular arrhythmias.BACKGROUND Coronary artery revascularization is an effective treatment for myocardial ischemia; however, its effect on ventricular arrhythmias not related to an acute ischemic event has not been carefully studied.METHODS Sixty-four patients (58 men, mean age 65 +/- 8 years old) with prior myocardial infarction, spontaneous ventricular arrhythmias not related to an acute ischemic event (55 ventricular tachycardia, 9 ventricular fibrillation) and coronary lesions requiring revascularization were studied prospectively. Electrophysiological study was performed before and after revascularization, and events during follow-up were analyzed.RESULTS At initial study 61 patients were inducible into sustained ventricular arrhythmias. After revascularization, in 62 survivors, 52 out of 59 patients previously inducible were still inducible (group A), and 10 patients were noninducible (group B). No differences were found in clinical, hemodynamic, therapeutic and electrophysiological characteristics between both groups. During 32 +/- 26 months follow-up, 28/52 patients in group A (54%) and 4/10 patients in group B (40%) had arrhythmic events (p = 0.46). An ejection fraction