Stamato N J, O'Connell J B, Murdock D K, Moran J F, Loeb H S, Scanlon P J
Am Heart J. 1986 Sep;112(3):505-8. doi: 10.1016/0002-8703(86)90514-4.
A prospective study was undertaken to assess the response of patients with idiopathic dilated cardiomyopathy to programmed electrical stimulation (PES). Fifteen patients undergoing evaluation of congestive heart failure were studied. All patients underwent cardiac catheterization and coronary angiography as well as endomyocardial biopsy to exclude known causes of heart failure. No patient had a history of syncope or sustained ventricular arrhythmias. All patients were found to have severe left ventricular dysfunction (mean ejection fraction 17%), as well as nonsustained ventricular tachycardia on ambulatory monitoring or exercise testing. A protocol using up to two premature stimuli and burst pacing, from two right ventricular sites, induced up to four repetitive ventricular responses but failed to induce a sustained ventricular arrhythmia in any patient. Patients with dilated cardiomyopathy, advanced ventricular arrhythmias, and depressed left ventricular function respond differently than do patients with coronary artery disease, advanced ventricular arrhythmias, and depressed left ventricular function, to PES. PES appears to have limited value in the evaluation of patients with dilated cardiomyopathy and nonsustained ventricular arrhythmias.
开展了一项前瞻性研究，以评估特发性扩张型心肌病患者对程控电刺激（PES）的反应。对15例接受充血性心力衰竭评估的患者进行了研究。所有患者均接受了心导管检查、冠状动脉造影以及心内膜心肌活检，以排除已知的心力衰竭病因。所有患者均无晕厥或持续性室性心律失常病史。所有患者均被发现有严重的左心室功能障碍（平均射血分数17%），并且在动态监测或运动试验中出现非持续性室性心动过速。一项使用来自两个右心室部位的最多两个期前刺激和短阵快速起搏的方案，诱发了最多四次重复性心室反应，但未能在任何患者中诱发持续性室性心律失常。扩张型心肌病、晚期室性心律失常和左心室功能降低的患者对PES的反应与冠状动脉疾病、晚期室性心律失常和左心室功能降低的患者不同。PES在评估扩张型心肌病和非持续性室性心律失常患者时似乎价值有限。
