Prognostic significance of ventricular tachycardia and fibrillation induced at programmed stimulation and delayed potentials detected on the signal-averaged electrocardiograms of survivors of acute myocardial infarction.
Prognostic significance of ventricular tachycardia and fibrillation induced at programmed stimulation and delayed potentials detected on the signal-averaged electrocardiograms of survivors of acute myocardial infarction.
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急性心肌梗死幸存者的信号平均心电图上检测到的程序刺激和延迟电位引起的室性心动过速和颤动的预后意义。
作者：
A. Denniss;David Richards;D. V. Cody;P. Russell;A. Young;Mark J. Cooper;David L. Ross;J. Uther
在一项前瞻性研究中，对403例65岁或以下的透壁性心肌梗死的临床良好幸存者进行了比较，比较了急性心肌梗死1个月内程控刺激诱导的室性心动过速和室颤的相对预后意义。在306例无束分支传导阻滞的患者中，对信号平均心电图上延迟电位的预后意义进行了研究。在研究患者中，20%有可诱导的室性心动过速，14%有可诱导的室颤，66%没有可诱导的心律失常。2年内无心源性死亡或非致死性室性心动过速或室颤的概率为：可诱导室性心动过速患者为0.73，可诱导室颤患者为0.93，无可诱导心律失常患者为0.92。70%死亡的诱导性室性心动过速患者的诱导性室性心动过速周期长度≥ 230 msec。在通过信号平均心电图研究的患者中，26%有延迟电位。2年时，延迟电位患者保持无心源性死亡或非致命性室性心动过速或室颤的概率为0.73，无延迟电位患者为0.95。延迟电位的存在与诱发室性心动过速的能力之间存在显著相关性（p <0.001）。总之，在近期梗死的幸存者中，如果没有自发性室性心动过速或室颤，程控刺激下的诱导性心动过速（但不是诱导性室颤）预示着死亡或自发性心动过速或室颤的显著风险。在信号平均心电图上有延迟电位的患者中发现了类似的风险。
The relative prognostic significance of ventricular tachycardia and ventricular fibrillation inducible at programmed stimulation within 1 month of acute myocardial infarction was compared in a prospective study of 403 clinically well survivors of transmural infarction who were 65 years old or younger. The prognostic significance of delayed potentials on the signal-averaged electrocardiogram was also examined in a subset of 306 patients without bundle branch block. Among the study patients, 20% had inducible ventricular tachycardia, 14% had inducible ventricular fibrillation, and 66% had no inducible arrhythmias. The 2 year probability of remaining free from cardiac death or nonfatal ventricular tachycardia or fibrillation was 0.73 for those with inducible ventricular tachycardia, 0.93 for those with inducible ventricular fibrillation, and 0.92 for those with no inducible arrhythmias. The cycle length of inducible ventricular tachycardia was 230 msec or more in 70% of the patients with inducible tachycardia who died. Of the patients studied by signal-averaged electrocardiography, 26% had delayed potentials. At 2 years, the probability of remaining free from cardiac death or nonfatal ventricular tachycardia or fibrillation was 0.73 for patients with delayed potentials and 0.95 for patients with no delayed potentials. There was a significant correlation (p less than .001) between the presence of delayed potentials and the ability to induce ventricular tachycardia. In conclusion, in survivors of recent infarction who have not had spontaneous ventricular tachycardia or fibrillation, inducible tachycardia (but not inducible fibrillation) at programmed stimulation predicts a significant risk of death or spontaneous tachycardia or fibrillation. A similar risk is found for patients with delayed potentials on the signal-averaged electrocardiogram.
对 15 名自发性心室颤动患者的动态心电图进行分析，特别参考之前的心律失常事件。
影响因子：
24
作者：
Pratt,CM;Francis,MJ;Luck,JC;Wyndham,CR;Miller,RR;Quinones,MA
通讯作者：
Quinones,MA
通过信号平均心电图的频率分析，改进了对程序性心室刺激的患者的选择。
影响因子：
37.8
作者：
Lindsay,BD;Ambos,HD;Schechtman,KB;Cain,ME
通讯作者：
Cain,ME