Zvizdic H, Gloor H, Steinbrunn W, Egloff L, Turina M
Medizinische Klinik, Universitätsspital, Zürich.
Schweiz Med Wochenschr. 1988 May 14;118(19):708-15.
In a retrospective study we analyzed the long-term course in 77 patients (71 males and 6 females) with symptomatic ventricular tachycardias. Initially all patients had undergone an electrophysiological examination. 56/77 patients received drug therapy and 19/77 underwent surgery (implantation of an automatic defibrillator in 2 patients). Two patients received no therapy. After an observation period of 30 (5-81) months, 60% of the patients who had received drug therapy and 77% who had undergone surgery were free of tachycardia. 16/56 (29%) of the patients under drug management and 6/19 (32%) of the surgically treated had died in the meantime. In the whole group the mortality rate was 9.6 times higher than in an age and sex matched control group. In younger subjects (16-50 years) the mortality rate was 4 times greater than in those aged 51-81 years. The highest mortality was observed in the first year. The most important prognostic parameter was the left ventricular ejection fraction, which was significantly higher in survivors. We conclude that ventricular arrhythmias can be effectively controlled, and quality of life enhanced, with drug therapy or surgery.
在一项回顾性研究中,我们分析了77例有症状室性心动过速患者(71例男性和6例女性)的长期病程。所有患者最初均接受了电生理检查。77例患者中,56例接受了药物治疗,19例接受了手术(2例植入自动除颤器)。2例患者未接受治疗。经过30(5 - 81)个月的观察期后,接受药物治疗的患者中有60%、接受手术治疗的患者中有77%无心动过速发作。在此期间,接受药物治疗的患者中有16/56(29%)、接受手术治疗的患者中有6/19(32%)死亡。在整个研究组中,死亡率比年龄和性别匹配的对照组高9.6倍。在较年轻的受试者(16 - 50岁)中,死亡率比51 - 81岁的受试者高4倍。第一年的死亡率最高。最重要的预后参数是左心室射血分数,幸存者的该参数明显更高。我们得出结论,药物治疗或手术可以有效控制室性心律失常,并提高生活质量。