Comparison of programmed electrical stimulation and ambulatory electrocardiographic (Holter) monitoring in the management of ventricular tachycardia and ventricular fibrillation.
Comparison of programmed electrical stimulation and ambulatory electrocardiographic (Holter) monitoring in the management of ventricular tachycardia and ventricular fibrillation.
复制标题
程序化电刺激和动态心电图（动态心电图）监测在室性心动过速和心室颤动治疗中的比较。
DOI：
10.1016/s0735-1097(84)80092-3
复制
发表时间：
1984
影响因子：
24
通讯作者：
Reid,PR
中科院分区：
文献类型：
--
作者：
Platia,EV;Reid,PR
44例原发性室颤或复发性室性心动过速患者在进行电生理检查和24 ~ 72小时动态心电图监测前接受抗心律失常药物治疗。然后回顾性比较这两种检测的长期预测价值，随访12至32个月（平均18个月），在此期间，所有患者继续接受相同的抗肿瘤药物治疗方案。26例患者的电生理检查诱发室性心动过速（≥ 3次搏动）; 23例患者的临床结局较差（阳性预测值88%），定义为猝死或持续性室性心动过速。在18例电生理检查阴性的患者中，只有1例临床结局较差（阴性预测值94%）。动态心电图监测准确预测了10例阳性记录患者中的7例结果（阳性预测值70%），定义为三次或三次以上连续室性期外收缩，34例动态监测阴性患者中有17例（阴性预测值50%）。电生理检查的远期预测准确性明显高于动态心电图（P < 0.001）。电生理学研究在这一高风险患者组中提供了优于动态心电图监测的优势，在预测至少18个月的抗心律失常药物的长期临床反应方面提供了高度的准确性。
Forty-four patients with primary ventricular fibrillation or recurrent ventricular tachycardia were stabilized on an antiarrhythmic drug regimen before electrophysiologic study and 24 to 72 hours of ambulatory electrocardiographic monitoring were performed. The longterm predictive value of these two tests was then compared retrospectively for a 12 to 32 month (mean 18) follow-up period, during which all patients continued receiving the same antiarrhythmic drug regimen. Electrophysiologic testing induced ventricular tachycardia (≥ 3 beats) in 26 patients; 23 had a poor clinical outcome (positive predictive value 88%), defined as sudden death or sustained ventricular tachycardia. In 18 patients with a negative electrophysiologic test, only 1 had a poor clinical outcome (negative predictive value 94%).Ambulatory electrocardiographic monitoring accurately predicted outcome in 7 of 10 patients with a positive recording (positive predictive value 70%), defined as three or more consecutive ventricular extrasystoles, and in 17 of 34 patients with negative ambulatory monitor recordings (negative predictive value 50%). The longterm predictive accuracy of the electrophysiologic study was significantly higher than that of the ambulatory electrocardiographic monitor (p < 0.001). Electrophysiologic studies offer advantages over ambulatory electrocardiographic monitoring in this high risk patient group, providing a high degree of accuracy in predicting the long-term clinical response to antiarrhythmic drugs for at least 18 months.