Lin H T, Mann D E, Luck J C, Krafchek J, Magro S A, Sakun V, Wyndham C R
Am J Cardiol. 1987 Mar 1;59(6):559-63. doi: 10.1016/0002-9149(87)91169-6.
Thirty-eight patients who had sustained monomorphic ventricular tachycardia (VT) or sudden cardiac death underwent programmed ventricular stimulation. To assess the relative efficacy of right and left ventricular (RV and LV) stimulation, a tandem protocol with 1 to 4 extrastimuli and burst pacing was used. Each step of the protocol was performed in a rotating sequence at the RV apex, basal RV septum and LV apex. Sustained VT was induced from the RV apex in 26 patients, right ventricle (either site) in 27, and LV apex in 24, and spontaneous VT was reproduced from those sites in 11, 14 and 12 patients, respectively. In the 23 patients who had sustained VT induced from both ventricles, RV stimulation always required fewer or the same number of extrastimuli for induction. At every stage of the protocol, the cumulative yield of sustained VT was consistently greater from the right ventricle than from the left ventricle. After delivering 4 extrastimuli and burst pacing, LV stimulation only increased the yield of sustained VT by 1 patient, and spontaneous VT by 3 patients. Inducibility or noninducibility in the right ventricle generally predicted the same outcome in the left ventricle. Previously undocumented VT or ventricular fibrillation was induced from the right ventricle in 19 patients and from the left ventricle in 13. Thus, LV stimulation was less efficacious than RV stimulation. LV stimulation increased the yield over RV stimulation only minimally and did not reduce the number of extrastimuli required to induce sustained VT.
38例发生单形性室性心动过速（VT）或心脏性猝死的患者接受了程控心室刺激。为评估右心室和左心室（RV和LV）刺激的相对疗效，采用了包含1至4个期外刺激和短阵猝发刺激的串联方案。该方案的每一步均按顺序在右心室心尖部、右心室基底部间隔和左心室心尖部轮流进行。26例患者从右心室心尖部诱发出持续性VT，27例从右心室（任一部位）诱发出，24例从左心室心尖部诱发出，分别有11例、14例和12例患者从这些部位诱发出自发性VT。在23例从两个心室均诱发出持续性VT的患者中，右心室刺激诱发VT时所需的期外刺激数量总是更少或相同。在方案的每个阶段，右心室持续性VT的累积诱发率始终高于左心室。在给予4个期外刺激和短阵猝发刺激后，左心室刺激仅使持续性VT的诱发例数增加1例，自发性VT增加3例。右心室的可诱发性或不可诱发性通常预示着左心室的相同结果。19例患者从右心室诱发出既往未记录的VT或室颤，13例从左心室诱发出。因此，左心室刺激的疗效低于右心室刺激。左心室刺激仅比右心室刺激略微增加了诱发例数，且并未减少诱发出持续性VT所需的期外刺激数量。
