Kasanuki H, Onishi S, Hirosawa K
Jpn Circ J. 1985 Mar;49(3):351-61. doi: 10.1253/jcj.49.351.
In 96 cases of paroxysmal tachycardia, results of chronic pharmacological assessment (CPA) were compared with acute electrophysiological-pharmacologic assessments (EPA) to evaluate the usefulness of EPA. I. Patients with sustained VT (31 cases): Sustained VT and repetitive ventricular response (RVR) could be induced in 61% and 23% respectively. More than one effective drug was found by EPA for 23 of 24 subjects. Of the 22 followed by CPA, the effectiveness of medication was excellent for 14 (64%), moderate for 1, slight for 4, and ineffective for 3 (14%). II. Patients with non-sustained VT (23 cases): RVR could be induced in 52%. Effective medication was identified by EPA for 8 of 10 patients. Of the 7 followed by CPA, the effectiveness of medication was excellent for 2(28.5%) moderate for 2, and ineffective for 3. III. Patients with PSVT (42 cases): PSVT could be induced in 90% of cases. Effective medication was found for all 31 cases which underwent EPA. Of the 23 cases followed by CPA, the chronic efficacy of drugs was excellent for 7 (30%), moderate for 5 (22%), slight for 7 (30%), and noneffective for 4 (18%). Therefore, we conclude that the usefulness of EPA differs according to the type of tachycardia. EPA is most useful in predicting chronic results for patients with sustained VT, especially when the sustained VT is readily reproducible by electrical stimulation. It is less useful for nonsustained VT and PSVT. With nonsustained VT, EPA is limited by difficulty in repeatedly inducing RVR, and by difficulty in predicting the appropriate medication for chronic oral therapy. With PSVT, even though the PSVT can be induced with greater success, EPA is limited by variations in pharmacologic effects over time, which create discrepancies between EPA and CPA.
在96例阵发性心动过速患者中，比较了慢性药物评估（CPA）结果与急性电生理药理学评估（EPA）结果，以评估EPA的实用性。一、持续性室性心动过速（VT）患者（31例）：持续性VT和反复心室反应（RVR）的诱发率分别为61%和23%。EPA发现24例受试者中有23例存在一种以上有效药物。在随后接受CPA的22例患者中，药物疗效极佳的有14例（64%），中等的1例，轻微的4例，无效的3例（14%）。二、非持续性VT患者（23例）：RVR诱发率为52%。EPA确定10例患者中有8例有有效药物。在随后接受CPA的7例患者中，药物疗效极佳的2例（28.5%），中等的2例，无效的3例。三、阵发性室上性心动过速（PSVT）患者（42例）：90%的病例可诱发PSVT。接受EPA的31例患者均发现有有效药物。在随后接受CPA的23例患者中，药物的长期疗效极佳的7例（30%），中等的5例（22%），轻微的7例（30%），无效的4例（18%）。因此，我们得出结论，EPA的实用性因心动过速类型而异。EPA在预测持续性VT患者的长期结果方面最有用，尤其是当持续性VT可通过电刺激轻易重复诱发时。对非持续性VT和PSVT的作用较小。对于非持续性VT，EPA受到反复诱发RVR困难以及预测慢性口服治疗合适药物困难的限制。对于PSVT，尽管PSVT诱发成功率较高，但EPA受到药物效应随时间变化的限制，这导致EPA和CPA之间存在差异。
