IMPULSE PROPAGATION AT ISCHEMIA BOUNDARIES

这项研究的目的是：1)确定高危患者 急性心肌梗死后室性心律失常猝死 心肌梗死，以及2)减少这种情况的发生率 那些被确定为最高风险的患者的并发症。 研究人群将由大约425名幸存者组成 有一种或多种常规风险的心肌梗死患者 导致随后心源性猝死的因素。这些病人会 接受有计划的电生理检查(EPS) 脑室刺激；最多3个脑室外刺激 试图引发室性心动过速 (Vt)；那些没有诱导性室性心动过速的患者将接受 仅限β-肾上腺素能阻滞剂。有多少患者患有 在EPS的诱导性室速，一组将接受β-受体阻滞剂治疗 只有在另一组接受EPS引导的抗心律失常药物时 在β-受体阻滞剂的基础上进行治疗。这三个小组将是 长期随访，判断EPS结果是否 更准确地预测随后的心脏性猝死 目前的技术，以及预防性治疗是否由 EPS可以预防易感患者的心脏性猝死。

The aims of this study are: 1) to identify patients at highest risk of sudden death from ventricular arrhythmia following an acute myocardial infarction, and 2) to reduce the incidence of this complication in those patients identified to be at highest risk. The study population will consist of approximately 425 survivors of myocardial infarction who have one or more conventional risk factors for subsequent sudden cardiac death. These patients will receive electrophysiologic study (EPS) with programmed ventricular stimulation; Up to 3 ventricular extrastimuli will be administered in an attempt to induce ventricular tachycardia (VT). Those patients without inducible VT will be teated with a beta adrenergic blocking agent only. Of the patients with inducible VT at EPS, one group will receive beta blockade therapy only, while another group will receive EPS-guided antiarrhythmic therapy in additional to beta blockade. These three groups will be followed long-term to determine whether the results of EPS predict subsequent sudden cardiac death more accurately than current techniques, and whether prophylactic therapy guided by EPS can prevent sudden cardiac death in susceptible patients.