Nalos P C, Gang E S, Mandel W J, Myers M R, Oseran D S, Lass Y, Peter T
Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048.
Am Heart J. 1988 Jan;115(1 Pt 1):108-14. doi: 10.1016/0002-8703(88)90525-x.
The utility of the signal-averaged electrocardiogram (SAECG) for predicting ventricular tachycardia (VT) induction in patients presenting with sustained VT or ventricular fibrillation (VF) while on an empirically chosen antiarrhythmic agent was assessed in 17 patients. At the time of presentation with a malignant arrhythmia, 12 patients were taking quinidine, three patients were taking procainamide, and two patients were taking flecainide. All patients underwent programmed ventricular stimulation when not taking antiarrhythmic drugs; 12 patients had no inducible sustained VT and five patients had inducible sustained monomorphic VT. The SAECG done in the control state without antiarrhythmic agents was negative for late potentials in 11 of 12 patients in the noninducible group and positive for late potentials in four of five patients in the inducible group (sensitivity = 80% and specificity = 92%). We conclude that in patients presenting with life-threatening ventricular arrhythmias while taking an antiarrhythmic drug, the SAECG distinguishes patients with possible proarrhythmic events from those who have the substrate for inducible sustained VT.
在17例患者中评估了信号平均心电图（SAECG）在预测服用经验性选择的抗心律失常药物的持续性室性心动过速（VT）或心室颤动（VF）患者诱发室性心动过速方面的效用。在出现恶性心律失常时，12例患者服用奎尼丁，3例患者服用普鲁卡因胺，2例患者服用氟卡尼。所有患者在未服用抗心律失常药物时均接受了程控心室刺激；12例患者不能诱发出持续性室性心动过速，5例患者可诱发出持续性单形性室性心动过速。在未使用抗心律失常药物的对照状态下进行的SAECG检查显示，在不能诱发室性心动过速的12例患者中有11例晚期电位为阴性，在可诱发室性心动过速的5例患者中有4例晚期电位为阳性（敏感性 = 80%，特异性 = 92%）。我们得出结论，对于服用抗心律失常药物时出现危及生命的室性心律失常的患者，SAECG可将可能发生促心律失常事件的患者与具有可诱发持续性室性心动过速基质的患者区分开来。
