急性心肌梗死幸存者中程控心室刺激的预后意义
Prognostic significance of programmed ventricular stimulation in survivors of acute myocardial infarction.
作者信息
Bhandari A K, Hong R, Kotlewski A, McIntosh N, Au P, Sankoorikal A, Rahimtoola S H
机构信息
Department of Medicine, LAC-USC Medical Center.
出版信息
Br Heart J. 1989 May;61(5):410-6. doi: 10.1136/hrt.61.5.410.
The prognostic significance of the response to programmed ventricular stimulation was studied in 75 stable survivors of acute myocardial infarction. Programmed ventricular stimulation induced sustained ventricular arrhythmias in 33 (44%) patients and did not induce these arrhythmias in 42 (56%) patients. During a mean follow up of 18 months, four patients died suddenly and three developed spontaneous sustained ventricular tachycardia. The occurrence of arrhythmic events was not significantly different in patients with inducible sustained arrhythmias and those without, but such events were predicted by the presence of mild congestive heart failure. Although the inducibility of sustained ventricular tachycardia (but not ventricular fibrillation) seemed to identify a high risk subset with an arrhythmic event rate of 21% compared with 5.5% in others, it had a low sensitivity (57%) and a low positive predictive accuracy (21%) for arrhythmic events. Programmed ventricular stimulation is not helpful in identifying a subset of patients at high risk after an uncomplicated acute myocardial infarction.
在75例急性心肌梗死稳定存活者中研究了程序性心室刺激反应的预后意义。程序性心室刺激在33例（44%）患者中诱发了持续性室性心律失常，在42例（56%）患者中未诱发这些心律失常。在平均18个月的随访期间，4例患者突然死亡，3例发生自发性持续性室性心动过速。可诱发性持续性心律失常患者和无此情况患者的心律失常事件发生率无显著差异，但轻度充血性心力衰竭的存在可预测此类事件。虽然持续性室性心动过速（而非心室颤动）的可诱发性似乎可识别出一个高危亚组，其心律失常事件发生率为21%，而其他患者为5.5%，但其对心律失常事件的敏感性较低（57%），阳性预测准确性也较低（21%）。程序性心室刺激无助于识别无并发症急性心肌梗死后的高危患者亚组。
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