Borggrefe M, Breithardt G
Eur Heart J. 1986 Sep;7(9):735-42. doi: 10.1093/oxfordjournals.eurheartj.a062134.
The value of serial electrophysiologic testing in predicting the outcome of patients receiving amiodarone is controversial. Thirty-six patients with drug-refractory sustained ventricular tachyarrhythmias underwent serial electrophysiologic drug testing. All patients had inducible sustained ventricular tachyarrhythmias off any antiarrhythmic medication. After an oral amiodarone loading regimen there was no change in inducibility in 23 patients (group I), whereas ventricular tachycardia was made more difficult to induce in 5 patients, i.e. sustained ventricular tachycardia was only inducible using a basic drive which was 40 bpm faster than during control (group II). In the remaining 8 patients, induction of ventricular tachycardia was suppressed (group III). During follow-up of 11 +/- 12.3 months, 6 patients in group I had a recurrence of ventricular tachycardia and 2 died suddenly, whereas the course of groups II and III patients was uneventful (P less than 0.03, Breslow; P less than 0.01, Mantel-Cox). The predictive accuracy of the response to serial electrophysiologic testing during amiodarone therapy was 64%, the sensitivity was 46% and the specificity 100%. Thus, serial electrophysiologic drug testing is useful in determining prognosis and predicts the long-term response to amiodarone therapy in patients with ventricular tachyarrhythmias using a graded stimulation protocol.
连续电生理检查在预测接受胺碘酮治疗患者的预后方面的价值存在争议。36例药物难治性持续性室性心律失常患者接受了连续电生理药物检查。所有患者在未使用任何抗心律失常药物时均可诱发出持续性室性心律失常。在口服胺碘酮负荷方案后，23例患者（I组）的可诱发性无变化，而5例患者的室性心动过速更难诱发，即仅使用比对照时快40次/分的基础驱动频率才能诱发出持续性室性心动过速（II组）。其余8例患者的室性心动过速诱发被抑制（III组）。在11±12.3个月的随访期间，I组有6例患者室性心动过速复发，2例猝死，而II组和III组患者的病程平稳（Breslow检验，P<0.03；Mantel-Cox检验，P<0.01）。胺碘酮治疗期间连续电生理检查反应的预测准确性为64%，敏感性为46%，特异性为100%。因此，连续电生理药物检查对于使用分级刺激方案的室性心律失常患者确定预后及预测胺碘酮治疗的长期反应是有用的。
