Chadda K D, Harrington D, Kushnik H, Bodenheimer M M
Am Heart J. 1986 Dec;112(6):1159-65. doi: 10.1016/0002-8703(86)90344-3.
A post hospital follow-up system based on predetermined antiarrhythmic strategies and telephone transmitters used to record ECGs was helpful in managing post hospital course and improved survival in patients with a history of out-of-hospital sudden death. All patients underwent therapy guided by serial electrophysiologic testing. Of the 47 patients, 19 used the telephone transmitter system and 28 did not. During follow-up, residual symptomatic and silent ventricular arrhythmia was documented in 78% of patients using telephone transmitters. Ventricular tachycardia was transmitted in six patients--all survived. During an average 15-month follow-up, 1 of 19 patients using the telephone transmitter system died vs 12 deaths among the 28 patients who did not use the system (p less than 0.005). These results were independent of ejection fraction, presence of congestive heart failure, amiodarone therapy, and the outcome on electrophysiologic therapy. Thus, patients with a history of out-of-hospital sudden death, discharged following electrophysiologic guided therapy, require repeated antiarrhythmic dose titration for side effects or residual ventricular arrhythmia. Prompt diagnosis and treatment of potentially fatal arrhythmia is crucial and feasible, especially with regular ECG checks through telephone transmission.
一种基于预定抗心律失常策略和用于记录心电图的电话发射器的出院后随访系统，有助于管理出院后的病程，并提高有院外猝死史患者的生存率。所有患者均接受了连续电生理检查指导下的治疗。47例患者中，19例使用了电话发射器系统，28例未使用。随访期间，使用电话发射器的患者中有78%记录到有症状和无症状的室性心律失常残留。6例患者的室性心动过速被传输——所有患者均存活。在平均15个月的随访中，使用电话发射器系统的19例患者中有1例死亡，而未使用该系统的28例患者中有12例死亡（p<0.005）。这些结果与射血分数、充血性心力衰竭的存在、胺碘酮治疗以及电生理治疗的结果无关。因此，有院外猝死史、在电生理指导治疗后出院的患者，需要针对副作用或残留室性心律失常反复进行抗心律失常剂量滴定。及时诊断和治疗潜在致命性心律失常至关重要且可行，尤其是通过电话传输进行定期心电图检查。
