Andresen D, von Leitner E R, Wegscheider K, Schröder R
Dtsch Med Wochenschr. 1984 Apr 6;109(14):532-6. doi: 10.1055/s-2008-1069228.
The effect of a standardized psychological stress test on frequency and severity of ventricular extrasystoles was compared in 42 patients with the results of 24-hour ECG monitoring and of an exercise ECG test. Frequent ventricular extrasystoles (greater than 1/min) occurred in the 24-hour-ECG in 22, in the psychological stress test in 24 and on physical exercise in 22 patients. 24-hour monitoring gave the only positive finding in ten, the psychological stress test in six, the exercise test in four. Complex arrhythmias (coupled or runs of ventricular extrasystoles) occurred in the 24-hour ECG in 30, with the psychological stress test in 16 and the exercise test in 12 patients. The 24-hour ECG was alone positive in 16, the psychological test in two, the exercise test in one. Thus in an individual patient the psychological stress test may provoke additional arrhythmias which are not recorded in either the 24-hour ECG or after exercise. The findings point to an independent significance of the psychological stress test in the diagnosis of simple and complex ventricular arrhythmias.
在42例患者中,比较了标准化心理应激试验对室性期前收缩频率和严重程度的影响,并与24小时心电图监测结果及运动心电图试验结果进行对比。24小时心电图监测显示,22例患者出现频发室性期前收缩(大于1次/分钟);心理应激试验中,24例患者出现频发室性期前收缩;运动试验中,22例患者出现频发室性期前收缩。24小时监测仅在10例患者中得到阳性结果,心理应激试验在6例患者中得到阳性结果,运动试验在4例患者中得到阳性结果。30例患者在24小时心电图监测中出现复杂心律失常(室性期前收缩成对出现或成串出现),16例患者在心理应激试验中出现复杂心律失常,12例患者在运动试验中出现复杂心律失常。24小时心电图监测单独出现阳性结果的有16例,心理试验单独出现阳性结果的有2例,运动试验单独出现阳性结果的有1例。因此,对于个体患者,心理应激试验可能诱发额外的心律失常,而这些心律失常在24小时心电图监测或运动后均未记录到。这些发现表明心理应激试验在诊断简单和复杂室性心律失常方面具有独立的意义。