Freedman R A, Swerdlow C D, Soderholm-Difatte V, Mason J W
Cardiology Division, Stanford University Medical Center, California.
Am J Cardiol. 1988 Mar 1;61(8):578-82. doi: 10.1016/0002-9149(88)90768-0.
The value of arrhythmia inducibility or noninducibility at initial electrophysiologic study to predict the likelihood of arrhythmia recurrence was assessed in 150 consecutive survivors of cardiac arrest. Ventricular tachycardia (greater than or equal to 6 beats) or ventricular fibrilation was induced in 113 patients (75%); ventricular arrhythmia could not be induced in 37 patients (25%). During follow-up of a mean of 16 months (range 1 to 72), there were 65 arrhythmia recurrences, 34 of them fatal, in 58 patients. Multivariate regression analysis showed that inducibility at initial study of ventricular tachycardia or ventricular fibrilation was an independent predictor of total arrhythmia recurrence (p less than 0.0001) and fatal arrhythmia recurrence (p = 0.02). At 1 year, 25 +/- 5% of patients with an inducible arrhythmia had a fatal arrhythmia recurrence compared with only 4 +/- 4% of patients without (p = 0.003). The nature of the inducible arrhythmia had no additional predictive value. Inducibility or noninducibility of ventricular arrhythmias at initial electrophysiologic study is a powerful, independent predictor of subsequent arrhythmia recurrence in survivors of cardiac arrest. Patients without inducible arrhythmias have a low frequency of fatal arrhythmia recurrence.
在150例心脏骤停连续存活者中，评估了初始电生理研究中心律失常的可诱发性或不可诱发性对预测心律失常复发可能性的价值。113例患者（75%）诱发出室性心动过速（≥6次搏动）或室颤；37例患者（25%）未诱发出室性心律失常。在平均16个月（范围1至72个月）的随访期间，58例患者出现65次心律失常复发，其中34次为致命性复发。多因素回归分析显示，初始研究中室性心动过速或室颤的可诱发性是心律失常总复发（p<0.0001）和致命性心律失常复发（p=0.02）的独立预测因素。1年时，可诱发性心律失常患者中25±5%发生致命性心律失常复发，而无诱发性心律失常患者仅为4±4%（p=0.003）。可诱发性心律失常的性质无额外预测价值。初始电生理研究中室性心律失常的可诱发性或不可诱发性是心脏骤停存活者后续心律失常复发的有力独立预测因素。无诱发性心律失常的患者致命性心律失常复发频率较低。
