Borggrefe M, Karbenn U, Podczeck A, Martinez-Rubio A, Schwarzmaier J, Breithardt G
University Hospital of Düsseldorf, Department of Cardiology, F.R.G.
Herz. 1988 Jun;13(3):197-203.
The purpose of the paper is to review the presently available information of the effects of non-pharmacological interventions for the control of drug-refractory ventricular tachyarrhythmias on non-invasively recorded ventricular late potentials. During recent years, non-pharmacological interventions have evolved as an alternative form of treatment to control drug-refractory ventricular tachyarrhythmias. The effects of these non-pharmacological measures on ventricular late potentials are poorly understood. Successful surgical control of ventricular tachycardia often normalizes the signal averaged ECG and may eliminate delayed potentials. Thus, this non-invasive test may be useful in assessing surgical efficacy in subgroups of patients with ventricular tachycardia. However, the clinical value of late potentials in assessing surgical efficacy in the individual case may be limited as the sensitivity and specificity of the loss of late potentials after antitachycardia surgery are low. In addition, the effects of transvenous catheter ablation on ventricular late potentials will be reviewed. The available information suggests that this intervention has little effects on the presence or absence of late potentials. Thus, non-invasive recording of late potentials seems not to be helpful in predicting the acute and long-term efficacy of catheter ablation. In conclusion, changing of the parameters in the signal-averaged QRS complex after antitachycardia surgery may be useful in predicting the efficacy of surgical interventions for drug-refractory ventricular tachycardias in subgroups of patients. However, the sensitivity and predictive accuracy of this test are low, thus limiting its clinical usefulness.
本文的目的是回顾目前关于非药物干预控制药物难治性室性心律失常对无创记录的心室晚电位影响的可用信息。近年来，非药物干预已发展成为控制药物难治性室性心律失常的一种替代治疗形式。这些非药物措施对心室晚电位的影响尚不清楚。成功的室性心动过速手术控制通常可使信号平均心电图正常化，并可能消除延迟电位。因此，这种无创检查可能有助于评估室性心动过速患者亚组的手术疗效。然而，由于抗心动过速手术后晚电位消失的敏感性和特异性较低，晚电位在评估个体病例手术疗效中的临床价值可能有限。此外，还将回顾经静脉导管消融对心室晚电位的影响。现有信息表明，这种干预对晚电位的有无影响不大。因此，无创记录晚电位似乎无助于预测导管消融的急性和长期疗效。总之，抗心动过速手术后信号平均QRS波群参数的变化可能有助于预测药物难治性室性心动过速患者亚组手术干预的疗效。然而，该检查的敏感性和预测准确性较低，从而限制了其临床应用价值。
