Potratz Jürgen
Klinik für Allgemeine Innere Medizin, Kardiologie, Intensivmedizin, Hämatologie, Onkologie und Geriatrie, Med. Klinik I Agaplesion Diakonieklinikum Rotenburg/Wümme, Elise-Averdieck-Straße 17, 27356, Rotenburg, Deutschland,
Herzschrittmacherther Elektrophysiol. 2015 Mar;26(1):5-7. doi: 10.1007/s00399-015-0355-9. Epub 2015 Mar 7.
Programmed ventricular stimulation was used extensively in the 1970s and has markedly improved our knowledge about the electrophysiological mechanisms of reentrant ventricular arrhythmias. In numerous observational but also randomized studies, it was shown that the induction of a monomorphic ventricular tachycardia by programmed ventricular stimulation was associated with an increased risk of spontaneous ventricular tachycardia or even sudden cardiac death in the future. Despite these results and the guidelines of ACC and ESC recommending the use of programmed ventricular stimulation in patients with recent and remote myocardial infarction, reduced ejection fraction, and complex ventricular arrhythmias or syncope, programmed ventricular stimulation is only seldom used and does not play a relevant role in clinical practice today. The purpose of this overview is to reevaluate the importance of programmed ventricular stimulation for the risk evaluation of patients with ischemic heart disease in consideration of the current literature.
程控心室刺激在20世纪70年代被广泛应用,显著增进了我们对折返性室性心律失常电生理机制的认识。在众多观察性研究以及随机研究中,结果表明通过程控心室刺激诱发单形性室性心动过速与未来发生自发性室性心动过速甚至心源性猝死的风险增加相关。尽管有这些结果以及美国心脏病学会(ACC)和欧洲心脏病学会(ESC)的指南推荐在近期及陈旧性心肌梗死、射血分数降低、复杂性室性心律失常或晕厥患者中使用程控心室刺激,但如今程控心室刺激很少被使用,在临床实践中也未发挥重要作用。本综述的目的是结合当前文献重新评估程控心室刺激对缺血性心脏病患者风险评估的重要性。