Clinical significance of syncope in the electrophysiologic study versus electrocardiographic monitoring (ESVEM) trial. The ESVEM Investigators.
Clinical significance of syncope in the electrophysiologic study versus electrocardiographic monitoring (ESVEM) trial. The ESVEM Investigators.
复制标题
电生理学研究与心电图监测 (ESVEM) 试验中晕厥的临床意义。
DOI：
10.1016/s0002-8703(99)70412-6
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发表时间：
1999
影响因子：
4.8
通讯作者：
Mason,JW
中科院分区：
文献类型：
--
作者：
Olshansky,B;Hahn,EA;Hartz,VL;Prater,SP;Mason,JW
晕厥可能预示着死亡的风险，但晕厥患者的高风险仍不清楚。目的ESVEM试验是一项多中心随机前瞻性试验，旨在比较晕厥与自发性室性心律失常患者的死亡率。方法将ESVEM试验中25例晕厥患者（25例）或24例晕厥合并室性心动过速患者（24例）与332例自发性室性心动过速患者（332例）或105例自发性室颤患者（105例）进行比较。所有患者在霍尔特监测仪上每小时进行≥10次室性早搏电生理检查时均诱发室性快速心律失常。结果在所有随机分配的患者中，单纯晕厥、室性心动过速和晕厥、单纯室性心动过速或室颤患者的病死率和总病死率相同。1年时，所有患者的病死率和总病死率分别为21%和24%;仅晕厥患者的病死率和总病死率分别为30%和29%（P = NS）。在4年时，所有患者的窒息性死亡率和总死亡率分别为33%和42%;仅晕厥患者分别为37%和42%（P = NS）。结论晕厥与电生理检查诱发的室性快速性心律失常相关，提示死亡风险高，与有记录的自发性室性快速性心律失常患者相似。(Am Heart J 1999;137：878-86.）
Background Syncope may portend risk of death, but which patients with syncope are at high risk remains unclear. Objective The ESVEM trial, a multicenter randomized prospective trial, provided the opportunity to compare mortality rates of patients enrolled with syncope to those enrolled with spontaneous ventricular arrhythmias. Methods Patients enrolled in the ESVEM trial presenting with syncope alone (25 patients) or in combination with ventricular tachycardia (24 patients) were compared with patients with spontaneous ventricular tachycardia alone (332 patients) or ventricular fibrillation (105 patients). All patients had ventricular tachyarrhythmias induced at electrophysiology testing of ≥10 premature ventricular complexes per hour on Holter monitor. Results Of all patients randomly assigned, arrhythmic death and total mortality rates were the same for those with syncope alone, with ventricular tachycardia and syncope, with ventricular tachycardia alone, or with ventricular fibrillation. At 1 year, arrhythmic and total mortality rate for all patients was 21% and 24%, respectively; for patients with syncope alone, 30% and 29%, respectively (P = NS). At 4 years, arrhythmic death and total mortality rate for all patients was 33% and 42%, respectively; for patients with syncope alone, 37% and 42%, respectively (P = NS). Conclusion Syncope, associated with induced ventricular tachyarrhythmias at electrophysiologic testing, indicates high risk for death, similar to that of patients with documented spontaneous ventricular tachyarrhythmias. (Am Heart J 1999;137:878-86.)