Zheutlin T A, Roth H, Chua W, Steinman R, Summers C, Lesch M, Kehoe R F
Am Heart J. 1986 May;111(5):860-7. doi: 10.1016/0002-8703(86)90634-4.
Patients with complex ventricular ectopy (greater than or equal to Lown grade III) and organic heart disease (OHD) are at increased risk for sudden cardiac death. Despite this fact, many such patients will remain free of symptomatic ventricular arrhythmia and thus are unnecessarily exposed to antiarrhythmic drug toxicity and arrhythmic potentiation. Programmed stimulation (PS) was used to direct therapy in 88 patients with asymptomatic ventricular ectopy complicating OHD. Thirty-three had inducible ventricular tachycardia (VT) and underwent treatment. The 55 patients without inducible VT (less than or equal to 6 repetitive ventricular responses) are the focus of this study. Three patients required treatment for persistent cardiac awareness. The remaining 52 have been followed for 22 months off antiarrhythmic drugs and all have remained free of subsequent major arrhythmic events. Therefore, in patients with complex ventricular ectopy, OHD, and absence of prior symptomatic ventricular arrhythmia, PS identifies patients at low risk for future disabling or life-threatening arrhythmic episodes and patients with absence of inducible VT can usually be managed without antiarrhythmic drugs.
患有复杂性室性早搏（大于或等于洛恩三级）和器质性心脏病（OHD）的患者发生心源性猝死的风险增加。尽管如此，许多此类患者仍无症状性室性心律失常，因此不必要地暴露于抗心律失常药物毒性和心律失常增强作用之下。对88例伴有OHD的无症状室性早搏患者采用程序刺激（PS）指导治疗。33例诱发出室性心动过速（VT）并接受了治疗。本研究的重点是55例未诱发出VT的患者（小于或等于6次重复性室性反应）。3例患者因持续性心脏感知需要治疗。其余52例患者停用抗心律失常药物后随访了22个月，所有患者均未发生随后的重大心律失常事件。因此，对于患有复杂性室性早搏、OHD且既往无症状性室性心律失常的患者，PS可识别出未来发生致残性或危及生命的心律失常发作风险较低的患者，未诱发出VT的患者通常无需使用抗心律失常药物即可进行管理。
