Ferrick K J, Luce J, Miller S, Mercando A D, Kim S G, Roth J A, Fisher J D
Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York 10467.
Am J Cardiol. 1992 May 15;69(16):1296-9. doi: 10.1016/0002-9149(92)91224-r.
Although electrophysiologic studies are often used to assess antiarrhythmic drug efficacy in patients with ventricular tachycardia (VT), the reproducibility of these studies during therapy has not been definitively established. Confirmation studies were performed during drug therapy in 64 patients (51 men, mean age 63 years) with sustained ventricular arrhythmias induced during initial study to assess the reproducibility of drug effect. All patients had coronary artery disease. The stimulation protocol used included the serial introduction of up to 3 premature ventricular stimuli during sinus rhythm and with ventricular pacing at 2 pacing rates. Rapid ventricular pacing techniques were also used. Antiarrhythmic drug efficacy was confirmed in 77% of patients. Sustained VT was induced at repeat electrophysiologic study in 19% of patients during antiarrhythmic therapy that was previously thought to be effective. In summary, electrophysiologic study results during antiarrhythmic therapy exhibit significant day-to-day variability. Sustained VT can be induced during antiarrhythmic therapy that was previously defined as effective by programmed stimulation in a substantial number of patients.
尽管电生理研究常用于评估室性心动过速（VT）患者的抗心律失常药物疗效，但这些研究在治疗期间的可重复性尚未得到明确证实。在64例（51例男性，平均年龄63岁）患有在初始研究期间诱发的持续性室性心律失常的患者中，于药物治疗期间进行了验证性研究，以评估药物效果的可重复性。所有患者均患有冠状动脉疾病。所采用的刺激方案包括在窦性心律期间以及以两种起搏频率进行心室起搏时，连续引入多达3个室性早搏刺激。还使用了快速心室起搏技术。77%的患者抗心律失常药物疗效得到证实。在先前被认为有效的抗心律失常治疗期间，19%的患者在重复电生理研究时诱发了持续性室性心动过速。总之，抗心律失常治疗期间的电生理研究结果显示出显著的每日变异性。在大量患者中，先前通过程序刺激定义为有效的抗心律失常治疗期间可诱发持续性室性心动过速。
