Kim S G
Department of Medicine, Montefiore Medical Center-Montefiore Hospital, Bronx, New York 10467.
Am J Cardiol. 1988 Nov 3;62(14):7I-12I. doi: 10.1016/0002-9149(88)91341-0.
Programmed stimulation (PES) and ambulatory electrocardiographic (Holter) monitoring are both widely used to evaluate the efficacy of antiarrhythmic drugs in patients with recurrent ventricular tachycardia (VT). PES is sensitive but nonspecific, and Holter is specific but insensitive. A failure to suppress ventricular premature complexes (VPCs) on Holter during drug therapy predicts a poor outcome. A suppression of VPCs by drug therapy, however, does not preclude a poor outcome. If VT is no longer induced by PES during drug therapy, the patients will have a good outcome. A persistent induction of VT during drug therapy, however, does not preclude good outcomes. Therefore some investigators have suggested alternative PES efficacy criteria such as the changes in the rate of induced VT during therapy. Further studies should be conducted to confirm this. Because both methods have values and limitations, a combined use of the 2 methods is recommended to improve the clinician's ability to predict the outcome of antiarrhythmic therapy. Studies designed to prove that 1 method is better than the other may prove futile.
程控刺激（PES）和动态心电图（Holter）监测都广泛用于评估抗心律失常药物对复发性室性心动过速（VT）患者的疗效。PES敏感但缺乏特异性，而Holter具有特异性但不敏感。药物治疗期间Holter未能抑制室性早搏（VPC）预示预后不良。然而，药物治疗抑制VPC并不能排除预后不良。如果药物治疗期间PES不再诱发VT，患者预后良好。然而，药物治疗期间持续诱发VT并不能排除良好的预后。因此，一些研究者提出了替代的PES疗效标准，如治疗期间诱发VT的速率变化。应进行进一步研究予以证实。由于这两种方法都有价值和局限性，建议联合使用这两种方法以提高临床医生预测抗心律失常治疗结果的能力。旨在证明一种方法优于另一种方法的研究可能是徒劳的。
