Kuck K H, Kunze K P, Geiger M, Costard A, Schlüter M
Department of Cardiology, University Hospital Eppendorf, Hamburg, F.R.G.
Z Kardiol. 1987;76 Suppl 3:131-6.
Programmed electrical stimulation was performed in 54 consecutive patients with hypertrophic cardiomyopathy. Three patients had a history of cardiac arrest due to ventricular tachyarrhythmias (group A), eight patients had a history of syncope of unknown origin (group B), and 43 patients were "asymptomatic", i.e. they had no documented or suspected symptomatic ventricular arrhythmias (group C). There were no differences among the groups with respect to electrocardiographic, echocardiographic or hemodynamic data. Ventricular arrhythmias were induced by atrial and right and left ventricular stimulation with a maximum of two extrastimuli in 18 patients. Induced arrhythmias were repetitive ventricular response in six patients, nonsustained ventricular tachycardia in four, sustained ventricular tachycardia in five, and ventricular fibrillation in three patients. Ventricular tachycardia was always rapid with a mean cycle length of 194 +/- 20 ms. In one group A patient, rapid ventricular tachycardia was induced during atrial stimulation. The type and incidence of induced ventricular arrhythmias did not differ among the three groups. It is concluded that programmed stimulation with a maximum of two ventricular extrastimuli cannot distinguish between patients with hypertrophic cardiomyopathy who had either cardiac arrest or syncope or were "asymptomatic".
对54例连续性肥厚型心肌病患者进行了程控电刺激。3例患者有因室性快速心律失常导致心脏骤停的病史（A组），8例患者有不明原因晕厥病史（B组），43例患者“无症状”，即无记录或疑似有症状性室性心律失常（C组）。三组在心电图、超声心动图或血流动力学数据方面无差异。18例患者通过心房及右心室和左心室刺激诱发室性心律失常，最多给予两个额外刺激。诱发的心律失常中，6例患者为反复心室反应，4例为非持续性室性心动过速，5例为持续性室性心动过速，3例为心室颤动。室性心动过速总是很快，平均周期长度为194±20毫秒。1例A组患者在心房刺激期间诱发了快速室性心动过速。三组之间诱发的室性心律失常的类型和发生率无差异。结论是，最多给予两个心室额外刺激的程控刺激不能区分有心脏骤停或晕厥的肥厚型心肌病患者与“无症状”患者。
