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[缺血性心脏病患者动态心电图监测与程控心室刺激结果的比较评估]

[Comparative evaluation of the results of Holter monitoring and programmed ventricular stimulation in patients with ischemic heart disease].

作者信息

Dabrowski A, Kołodziej P, Krupienicz A, Drzewiecki J, Giec L, Trusz-Gluza M, Wnuk-Wojnar A, Kopeć P, Sredniawa B

机构信息

I Klinika Kardiologii IK SL. AM w Katowicach, Warszawie.

出版信息

Kardiol Pol. 1990 Jan;33(1):34-9.

PMID:2277476
Abstract

24-hour ECG Holter monitoring and programmed ventricular stimulation were performed in 81 patients (64 males and 17 females aged 35-65). No ++anti-arrhythythmic agents nor beta-blockers were administrated. 58 patients suffered from myocardial infarction in the past, and 38 had a history of ventricular tachycardia. Right atrial and ventricular stimulation (in 7 patients also left ventricular stimulation) was performed using stimuli of a 2 ms pulse width. 24-hour ECG Holter monitoring was recorded on a magnetic tape from two bipolar precordial leads. Both examinations results were compared to assess correlation between ECG Holter monitoring parameters and inducibility of VT or VF by programmed stimulation. Significant correlation was stated among occurrence of: 1) spontaneous sustained ventricular tachycardia and induced by stimulation monomorphic sustained VT (p less than 0.005) as well as estimated both sustained and nonsustained VT (p less than 0.010) 2) spontaneous nonsustained VT and induced by stimulation sustained or nonsustained monomorphic VT (p less than 0.025). There was no correlation between spontaneous ventricular arrhythmias estimated by Lown and Wolf's classification and possibility to induce monomorphic VT as well as between any of ECG Holter monitoring parameters and polymorphic VT or ventricular fibrillation induced by stimulation. Aggressiveness extent of stimulation protocol necessary to induce monomorphic VT was similar in patients with or without VT recorded by Holter method.

摘要

对81例患者(64例男性和17例女性,年龄35 - 65岁)进行了24小时动态心电图监测和程控心室刺激。未给予抗心律失常药物和β受体阻滞剂。58例患者既往有心肌梗死病史,38例有室性心动过速病史。使用脉宽为2 ms的刺激进行右心房和心室刺激(7例患者还进行了左心室刺激)。从两个双极胸前导联在磁带上记录24小时动态心电图监测。比较两项检查结果,以评估动态心电图监测参数与程控刺激诱发室性心动过速(VT)或心室颤动(VF)的诱导性之间的相关性。在以下情况之间存在显著相关性:1)自发性持续性室性心动过速与刺激诱发的单形性持续性室性心动过速(p < 0.005)以及估计的持续性和非持续性室性心动过速(p < 0.010);2)自发性非持续性室性心动过速与刺激诱发的持续性或非持续性单形性室性心动过速(p < 0.025)。根据Lown和Wolf分类法估计的自发性室性心律失常与诱发单形性室性心动过速的可能性之间,以及任何动态心电图监测参数与刺激诱发的多形性室性心动过速或心室颤动之间均无相关性。通过动态心电图方法记录有或无室性心动过速的患者中,诱发单形性室性心动过速所需的刺激方案的激进程度相似。

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