Moltedo Jose M, Iyer Ramesh V, Forman Howard, Fahey John, Rosenthal Geoffrey, Snyder Christopher S
Ochsner J. 2006 Winter;6(2):64-7.
In Wolff-Parkinson-White syndrome (WPW) patients the loss of pre-excitation in a single heartbeat during exercise stress testing (EST) is a predictor of low risk of sudden death. The purpose of this study was to: 1) assess the frequency of loss of pre-excitation in a single heartbeat during exercise testing, and 2) compare the cost of EST versus trans-catheter electrophysiology study (EPS) in the risk assessment of WPW patients.
A retrospective review of 50 cases of patients with WPW who underwent EST was conducted including demographics, history of supraventricular tachycardia, associated congenital heart disease, maximum heart rate achieved, and loss of pre-excitation in a single heartbeat. Hospital costs of EST and EPS were compared.
Of the 50 patients who underwent EST, 4 (8%), lost pre-excitation in a single heartbeat during EST. No differences were found regarding gender, age at diagnosis or EST, history of supraventricular tachycardia, presence of congenital heart disease or maximal heart rate. A cost comparison, utilizing the cost data: EST ($62.75) and EPS ($5,597) found EST to be a cost-saving approach in WPW patients. With 4 patients losing pre-excitation during EST, the cost saving of EST was $22,388 for this population of WPW patients.
A frequency of 8% loss of pre-excitation was found in a pediatric sample that underwent EST. Additionally, EST was shown to be a cost-saving strategy in risk assessment of pediatric WPW patients.
在预激综合征（WPW）患者中，运动负荷试验（EST）期间单次心跳中预激消失是猝死低风险的一个预测指标。本研究的目的是：1）评估运动试验期间单次心跳中预激消失的频率，以及2）比较EST与经导管电生理研究（EPS）在WPW患者风险评估中的成本。
对50例接受EST的WPW患者进行回顾性研究，包括人口统计学资料、室上性心动过速病史、相关先天性心脏病、达到的最大心率以及单次心跳中预激消失情况。比较了EST和EPS的医院成本。
在接受EST的50例患者中，有4例（8%）在EST期间单次心跳中预激消失。在性别、诊断时或EST时的年龄、室上性心动过速病史、先天性心脏病的存在或最大心率方面未发现差异。利用成本数据进行成本比较：EST（62.75美元）和EPS（5597美元）发现EST是WPW患者节省成本的方法。由于有4例患者在EST期间预激消失，对于这群WPW患者，EST节省的成本为22388美元。
在接受EST的儿科样本中发现预激消失的频率为8%。此外，EST被证明是儿科WPW患者风险评估中节省成本的策略。
