Gurevitz Osnat, Viskin Sami, Glikson Michael, Ballman Karla V, Rosales A Gabriela, Shen Win-Kuang, Hammill Stephen C, Friedman Paul A
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Am Heart J. 2004 Apr;147(4):649-54. doi: 10.1016/j.ahj.2003.11.012.
The prognostic significance of ventricular flutter (VFL) induced during programmed electrical stimulation (PES) is currently unknown.
This study examined patients who had PES-induced VFL and assessed their long-term prognosis compared with patients who had inducible sustained monomorphic ventricular tachycardia (SMVT).
Of 3414 patients undergoing PES, 74 (2%) had sustained VFL. They were compared with a group of 71 patients undergoing PES in the same time frame who had inducible SMVT. Patients with inducible VFL had a higher ejection fraction than patients with SMVT (0.39 vs 0.33; P =.05). More aggressive pacing was required for arrhythmia induction in patients with VFL, with more stimuli (2.7 +/- 0.5 vs 2.2 +/- 0.6; P <.01) and tighter S(2), S(3), and S(4) intervals. After a mean follow-up of 30 +/- 31 months, the mortality rate was 34% in patients with VFL and 30% in patients with SMVT (P =.41). No difference in the 2 groups in overall survival or a combined end point of sudden death or appropriate implantable cardioverter defibrillator shock was revealed with Kaplan-Meier analysis.
The long-term prognosis of patients with inducible VFL is similar to that of patients with inducible SMVT, even when VFL is induced with a relatively aggressive protocol.
程控电刺激（PES）期间诱发的心室扑动（VFL）的预后意义目前尚不清楚。
本研究对PES诱发VFL的患者进行了检查，并与可诱发持续性单形性室性心动过速（SMVT）的患者的长期预后进行了评估。
在3414例接受PES的患者中，74例（2%）发生了持续性VFL。将他们与同期接受PES且可诱发SMVT的71例患者进行比较。可诱发VFL的患者比SMVT患者的射血分数更高（0.39对0.33；P = 0.05）。VFL患者诱发心律失常需要更积极的起搏，刺激次数更多（2.7±0.5对2.2±0.6；P < 0.01），S(2)、S(3)和S(4)间期更短。平均随访30±31个月后，VFL患者的死亡率为34%，SMVT患者为30%（P = 0.41）。Kaplan-Meier分析显示，两组在总生存率或猝死或合适的植入式心律转复除颤器电击的联合终点方面无差异。
可诱发VFL的患者的长期预后与可诱发SMVT的患者相似，即使VFL是通过相对积极的方案诱发的。
