Zhou Xiaohong, Gunderson Bruce D, Olson Walter H
Tachyarrhythmia Research, Medtronic, Inc., Minneapolis, Minnesota 55432-3576, USA.
J Cardiovasc Electrophysiol. 2004 Jan;15(1):14-20. doi: 10.1046/j.1540-8167.2004.03154.x.
Nonsustained ventricular tachycardia (NSVT) is a frequent phenomenon in some patients with heart disease, but its association with sustained ventricular tachycardias (ventricular tachycardia [VT]/ventricular fibrillation [VF]) is still not clear. The aim of this study was to determine whether NSVT incidence was associated with sustained VT/VF in patients with an implantable cardioverter defibrillator (ICD).
Retrospective data analysis was conducted in 923 ICD patients with a mean follow-up of 4 months. NSVT and sustained VT/VF were defined as device-detected tachycardias. The incidence rates of NSVT and sustained VT/VF as well as ICD therapies were determined as episodes per patient. The NSVT index was defined as the product of NSVT episodes/day times the mean number of beats per episode, i.e., total beats/day. The NSVT index peak was defined as the highest value on or prior to the day with sustained VT/VF episodes. Patients (n = 393) with NSVT experienced a higher incidence of sustained VT/VF (17.2 +/- 63.0 episodes/patient) and ICD therapies (15.2 +/- 61.4 episodes/patient) than patients (n = 530) without NSVT (sustained VT/VF: 0.5 +/- 6.6 and therapies: 0.5 +/- 5.6; P < 0.0001). Approximately 74% of NSVT index peaks occurred on the same day or <3 days prior to sustained VT/VF episodes. The index was higher for peaks < or =3 days prior to the day with sustained VT/VF (94.3 +/- 140.1 total beats/day) than for peaks >3 days prior to the day with sustained VT/VF (32.7 +/- 55.9 total beats/day; P < 0.0001).
ICD patients with NSVT represent a population more likely to experience sustained VT/VF episodes with a temporal association between an NSVT surge and sustained VT/VF occurrence.
非持续性室性心动过速（NSVT）在一些心脏病患者中是常见现象，但其与持续性室性心动过速（室性心动过速[VT]/心室颤动[VF]）的关联仍不明确。本研究的目的是确定植入式心脏复律除颤器（ICD）患者中NSVT发生率是否与持续性VT/VF相关。
对923例ICD患者进行回顾性数据分析，平均随访4个月。NSVT和持续性VT/VF定义为设备检测到的心动过速。NSVT和持续性VT/VF的发生率以及ICD治疗次数按每位患者的发作次数确定。NSVT指数定义为NSVT发作次数/天乘以每次发作的平均心跳数，即每天的总心跳数。NSVT指数峰值定义为持续性VT/VF发作当天或之前的最高值。有NSVT的患者（n = 393）比无NSVT的患者（n = 530）发生持续性VT/VF的发生率更高（17.2±63.0次发作/患者）和ICD治疗次数更多（15.2±61.4次发作/患者）（持续性VT/VF：0.5±6.6次发作/患者和治疗次数：0.5±5.6次发作/患者；P < 0.0001）。约74%的NSVT指数峰值出现在持续性VT/VF发作当天或之前<3天。持续性VT/VF发作当天之前≤3天的峰值指数（94.3±140.1次总心跳数/天）高于持续性VT/VF发作当天之前>3天的峰值指数（32.7±55.9次总心跳数/天；P < 0.0001）。
有NSVT的ICD患者更有可能经历持续性VT/VF发作，且NSVT激增与持续性VT/VF发生之间存在时间关联。
