IMPULSE PROPAGATION AT ISCHEMIA BOUNDARIES

本研究的目的是：1）确定最高风险的患者 急性心肌梗死后室性心律失常导致猝死 心肌梗死，2）减少这种发病率 这些患者的并发症被确定为风险最高。 研究人群将由约425名幸存者组成 有一种或多种常规风险的心肌梗死患者 导致心脏性猝死的因素 这些患者将 接受电生理检查（EPS）， 心室刺激;最多将进行3次心室期外刺激 试图诱发室性心动过速 （VT）。 没有诱发性室性心动过速的患者将接受 仅β肾上腺素能阻滞剂。 患者的 EPS时的诱导性室性心动过速，一组将接受β受体阻滞治疗 只有，而另一组将接受EPS引导的抗肿瘤药物 除了β受体阻滞剂外， 这三个小组将在 长期跟踪，以确定是否EPS的结果 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源性猝死。

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.