Programmed electrical stimulation to determine the need for antiarrhythmic therapy in patients with complex ventricular ectopic activity.
Programmed electrical stimulation to determine the need for antiarrhythmic therapy in patients with complex ventricular ectopic activity.
复制标题
程序化电刺激可确定患有复杂心室异位活动的患者是否需要抗心律失常治疗。
DOI：
10.1016/0002-8703(86)90634-4
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发表时间：
1986
影响因子：
4.8
通讯作者：
R. Kehoe
中科院分区：
文献类型：
--
作者：
T. Zheutlin;H. Roth;W. Chua;R. Steinman;C. Summers;M. Lesch;R. Kehoe
患有复杂性心室异位（≥ Lown III 级）和器质性心脏病（OHD）的患者发生心源性猝死的风险增加。尽管如此，许多此类患者仍然没有症状性室性心律失常，因此不必要地暴露于抗心律失常药物毒性和心律失常增强。程序刺激 (PS) 用于指导 88 名伴有 OHD 的无症状心室异位患者的治疗。 33 人患有诱发性室性心动过速 (VT)，并接受了治疗。 55 例无诱导性室速（≤6 次重复心室反应）的患者是本研究的重点。三名患者需要治疗以维持持续的心脏意识。其余 52 名患者在停止服用抗心律失常药物后进行了 22 个月的随访，所有患者均未出现随后的重大心律失常事件。因此，对于患有复杂性室性异位、OHD 且既往没有症状性室性心律失常的患者，(1) PS 识别出未来发生致残或危及生命的心律失常发作的风险较低的患者，(2) 不存在诱导性室性心动过速的患者通常无需抗心律失常药物即可治疗。
Patients with complex ventricular ectopy (≥ Lown grade III) and organic heart disease (OHD) are at increased risk for sudden cardiac death. Despite this fact, many such patients will remain free of symptomatic ventricular arrhythmia and thus are unnecessarily exposed to antiarrhythmic drug toxicity and arrhythmic potentiation. Programmed stimulation (PS) was used to direct therapy in 88 patients with asymptomatic ventricular ectopy complicating OHD. Thirty-three had inducible ventricular tachycardia (VT) and underwent treatment. The 55 patients without inducible VT (≤6 repetitive ventricular responses) are the focus of this study. Three patients required treatment for persistent cardiac awareness. The remaining 52 have been followed for 22 months off antiarrhythmic drugs and all have remained free of subsequent major arrhythmic events. Therefore, in patients with complex ventricular ectopy, OHD, and absence of prior symptomatic ventricular arrhythmia, (1) PS identifies patients at low risk for future disabling or life-threatening arrhythmic episodes and (2) patients with absence of inducible VT can usually be managed without antiarrhythmic drugs.