Sager P T, Perlmutter R A, Rosenfeld L E, McPherson C A, Batsford W P
Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.
J Am Coll Cardiol. 1989 Feb;13(2):385-90. doi: 10.1016/0735-1097(89)90516-0.
The clinical significance of rapid self-terminating ventricular tachycardia induced during electrophysiologic study was prospectively evaluated in three patient groups with clinical ventricular arrhythmias. Group A (11 patients) had inducible rapid self-terminating ventricular tachycardia only (mean cycle length less than or equal to 250 ms and greater than or equal to 10 beats in duration). In Group B (22 patients) induction of this arrhythmia was followed by the induction of sustained ventricular tachycardia. In Group C (82 patients) sustained ventricular tachycardia was induced without preceding rapid self-terminating ventricular tachycardia. All clinical characteristics of Group B patients were similar to those of Group C patients but differed markedly from those of Group A patients. Compared with Group A patients, Group B patients had a lower left ventricular ejection fraction (32 +/- 13% versus 52 +/- 17%, p = 0.004) and a greater prevalence of coronary artery disease (82% versus 0%, p less than 0.0001), structural heart disease and a history of clinical sustained ventrical arrhythmias. Similarly, the induced self-terminating ventricular tachycardia differed in Group A and Group B patients. The arrhythmias in Group B patients were more often monomorphic, were more often induced with one or two extrastimuli and had a longer cycle length than those in Group A patients. In Group B patients, the electrophysiologic characteristics of the self-terminating and the sustained induced ventricular tachycardias were similar. Cardioversion was required in 50% of Group B patients compared with 27% of Group C patients (p = 0.038).(ABSTRACT TRUNCATED AT 250 WORDS)
在三组有临床室性心律失常的患者中，对电生理研究期间诱发的快速自限性室性心动过速的临床意义进行了前瞻性评估。A组（11例患者）仅可诱发出快速自限性室性心动过速（平均周长小于或等于250毫秒且持续时间大于或等于10次搏动）。B组（22例患者）诱发这种心律失常后接着诱发出持续性室性心动过速。C组（82例患者）诱发出持续性室性心动过速，且之前未出现快速自限性室性心动过速。B组患者的所有临床特征与C组患者相似，但与A组患者明显不同。与A组患者相比，B组患者左心室射血分数较低（32±13%对52±17%，p = 0.004），冠心病患病率更高（82%对0%，p<0.0001），有结构性心脏病以及临床持续性室性心律失常病史。同样，A组和B组患者诱发的自限性室性心动过速也不同。B组患者的心律失常更常为单形性，更常由一或两个期外刺激诱发，且周长比A组患者的更长。在B组患者中，自限性和持续性诱发性室性心动过速的电生理特征相似。50%的B组患者需要心脏复律，而C组患者为27%（p = 0.038）。（摘要截短于250词）
