Sulpizi A M, Friehling T D, Kowey P R
Am J Cardiol. 1987 Apr 1;59(8):841-5. doi: 10.1016/0002-9149(87)91103-9.
This study was undertaken to determine the value of electrophysiologic testing in 61 patients with nonsustained ventricular tachycardia (VT) (3 or more beats) on ambulatory monitoring and no history of sustained ventricular arrhythmia. The study group consisted of 38 patients with coronary artery disease (CAD), 9 with idiopathic dilated cardiomyopathy and 14 with a normal heart. Nonsustained VT (at least 3 but not more than 15 beats) was induced in 46%, sustained VT (more than 15 beats) in 15% and no VT in 39%. Sustained VT was induced more frequently in the presence of left ventricular dysfunction (p = 0.005) but was not related to the presence of CAD. Over a mean follow-up of 26 months, 10 patients died from cardiac causes (4 suddenly), including 1 patient with inducible sustained VT, 2 with nonsustained VT and 7 with no inducible VT. Inducibility was not related to survival, either as a single variable or when combined with CAD, left ventricular dysfunction or recent myocardial infarction. Left ventricular function alone was a good predictor of outcome. Of 46 patients with an ejection fraction of 35% more or in New York Heart Association functional class I or II, 3 (7%) died from cardiac causes, compared with 7 of 13 patients (54%) with an ejection fraction of less than 35% or in functional class III or IV (p = 0.0001). Thus, in patients with nonsustained VT, the incidence of sustained VT during electrophysiologic testing is low and is related to the degree of left ventricular dysfunction.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究旨在确定电生理检查对61例动态心电图监测发现非持续性室性心动过速（室速，3个或更多心搏）且无持续性室性心律失常病史患者的价值。研究组包括38例冠心病（CAD）患者、9例特发性扩张型心肌病患者和14例心脏正常的患者。46%的患者诱发出非持续性室速（至少3个但不超过15个心搏），15%的患者诱发出持续性室速（超过15个心搏），39%的患者未诱发出室速。在存在左心室功能障碍的情况下更频繁诱发出持续性室速（p = 0.005），但与CAD的存在无关。平均随访26个月，10例患者死于心脏原因（4例为猝死），包括1例可诱发出持续性室速的患者、2例非持续性室速患者和7例未诱发出室速的患者。诱发性与生存率无关，无论是作为单一变量还是与CAD、左心室功能障碍或近期心肌梗死联合分析时均如此。仅左心室功能是预后的良好预测指标。射血分数≥35%或纽约心脏协会功能分级为I或II级的46例患者中，3例（7%）死于心脏原因，相比之下，射血分数<35%或功能分级为III或IV级的13例患者中有7例（54%）死亡（p = 0.0001）。因此，在非持续性室速患者中，电生理检查期间持续性室速的发生率较低，且与左心室功能障碍的程度有关。（摘要截短至250字）
