A prospective randomized study of the clinical efficacy and safety of transvenous cardioversion for termination of ventricular tachycardia.
A prospective randomized study of the clinical efficacy and safety of transvenous cardioversion for termination of ventricular tachycardia.
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一项关于经静脉电复律终止室性心动过速的临床疗效和安全性的前瞻性随机研究。
DOI：
10.1161/01.cir.71.3.571
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发表时间：
1985
期刊：
影响因子：
37.8
通讯作者：
D. Pantopoulos
中科院分区：
文献类型：
--
作者：
J. Ciccone;S. Saksena;Y. Shah;D. Pantopoulos
通过前瞻性随机研究设计，对 22 名患有器质性心脏病和持续性 VT 的患者（19 名男性，3 名女性；平均年龄 64 +/- 9 岁）进行了经静脉复律终止持续性室性心动过速 (VT) 的临床疗效和安全性检查。患者被随机分配接受 0.03 至 2.2 J 的增量低能量方案（A 组，11 名患者）或 0.5 至 10.0 J 的增量高能量方案（B 组，11 名患者）。在对照（无药）状态下的电生理学研究和所有患者的连续抗心律失常药物测试期间进行了经静脉心脏复律。两组在人口统计学、疾病和功能状态以及电生理参数方面具有可比性。总共分析了 77 次 VT 发作（A 组，45 次；B 组，32 次）。经静脉复律终止 VT 的总体疗效为 62%（A 组 56% vs B 组 72%；p 小于 0.01）。抗心律失常药物治疗并未显着增强经静脉心脏复律的疗效（对照 59% vs 药物 65%；p 大于 0.2）。逐步判别分析将成功的经静脉复律与较长的 VT 周期长度（p 小于 0.0005）、较高的能量（p 小于 0.025）、较低的能量波形倾斜（p 小于 0.025）、较短的首次复律尝试时间（p 小于 0.025）以及较短的窦性心律 QRS 时限（p 小于 0.05）相关联。 VT 加速很常见（每次电击发生率 8%）。由于这种并发症，百分之三十一的增量电击方案被终止。复律后，短暂性心律失常很常见（缓慢性心律失常 23%，室上性快速心律失常 12%）。经静脉复律后电极导管移位的情况并不常见 (3%)。（摘要截断为 250 字）
The clinical efficacy and safety of transvenous cardioversion for termination of sustained ventricular tachycardia (VT) were examined by a prospective randomized study design in 22 patients (19 men, three women; mean age 64 +/- 9 years) with organic heart disease and sustained VT. Patients were randomly assigned to undergo an incremental low-energy protocol from 0.03 to 2.2 J (group A, 11 patients) or an incremental high-energy protocol from 0.5 to 10.0 J (group B, 11 patients). Transvenous cardioversion was performed during electrophysiologic studies in the control (drug-free) state and during serial antiarrhythmic drug testing in all patients. Both groups were comparable for demographic, disease and functional status, and electrophysiologic parameters. A total of 77 episodes of VT (group A, 45; group B, 32) were analyzed. The overall efficacy of transvenous cardioversion for termination of VT was 62% (group A 56% vs group B 72%; p less than .01). Antiarrhythmic drug therapy did not significantly enhance efficacy of transvenous cardioversion (control 59% vs drug 65%; p greater than .2). Stepwise discriminant analysis correlated successful transvenous cardioversion with longer VT cycle length (p less than .0005), higher energy (p less than .025), lower energy waveform tilt (p less than .025), shorter time to initial cardioversion attempt (p less than .025), and shorter QRS duration in sinus rhythm (p less than .05). Acceleration of VT was frequent (8% incidence per delivered shock). Thirty-one percent of all incremental shock protocols were terminated because of this complication. After cardioversion, transient arrhythmias were common (bradyarrhythmias 23%, supraventricular tachyarrhythmias 12%). Displacement of electrode catheters after transvenous cardioversion was uncommon (3%).(ABSTRACT TRUNCATED AT 250 WORDS)