Mathes P
Klinik Höhenried für Herz- und Kreislaufkrankheiten, Bernried, F.R.G.
Eur Heart J. 1987 Aug;8 Suppl D:79-81. doi: 10.1093/eurheartj/8.suppl_d.79.
From the data available so far it is apparent that in patients with stable angina, bypass graft surgery is not associated with any change in ventricular premature complexes or complex ventricular arrhythmias at rest or during exercise over a 1-5 year follow-up period despite the evidence of a substantial relief of exercise-induced ischaemia persisting for 5 years. In addition, ventricular arrhythmias are not predictive of sudden death except in a few patients, in whom ventricular tachycardia or ventricular fibrillation during exercise-induced ischaemia could be documented. Such exercise-induced arrhythmias appear to have a poor prognosis, unless the ischaemia is relieved by bypass surgery. The available literature suggests that ventricular arrhythmias at rest or during exercise in patients following bypass surgery are not related to ischaemia but to other unknown factors. Electrical instability during exercise may be caused by other factors rather than by ischaemia, and this phenomenon should be further investigated.
从目前可得的数据来看，很明显，在稳定型心绞痛患者中，尽管有证据表明运动诱发的缺血在5年内持续得到显著缓解，但在1至5年的随访期内，搭桥手术与静息或运动时室性早搏或复杂性室性心律失常的任何变化均无关联。此外，室性心律失常并非猝死的预测因素，只有少数患者除外，这些患者在运动诱发缺血期间可记录到室性心动过速或心室颤动。除非缺血通过搭桥手术得到缓解，否则这种运动诱发的心律失常预后似乎较差。现有文献表明，搭桥手术后患者静息或运动时的室性心律失常与缺血无关，而是与其他未知因素有关。运动期间的电不稳定可能由其他因素而非缺血引起，这一现象应进一步研究。
