Buxton A E, Waxman H L, Marchlinski F E, Josephson M E
Am J Cardiol. 1983 Nov 1;52(8):985-91. doi: 10.1016/0002-9149(83)90517-9.
Electrophysiologic studies were performed in 83 patients with spontaneous episodes of nonsustained ventricular tachycardia (VT). The clinical arrhythmia was reproduced in 63% (in 42 patients by programmed stimulation and in 10 by isoproterenol infusion). In 15 patients sustained VT could be reproducibly induced by programmed stimulation. Inducibility was related to the associated heart diseases: programmed stimulation induced VT in 25 of 33 patients (75%) with coronary disease, 6 of 18 patients (33%) with cardiomyopathy (dilated in 16, hypertrophic nonobstructive in 2), in 4 of 8 patients (50%) with mitral valve prolapse and in 7 of 24 patients (29%) without structural heart disease. Isoproterenol infusion induced VT in no other patient with coronary artery disease, 1 other patient with mitral valve prolapse, 3 patients with cardiomyopathy, and in 6 of 24 patients without structural heart disease. Sustained VT was induced only in patients with structural heart disease, and correlated with the presence of left ventricular aneurysms: Sustained VT was induced in 9 of 13 patients with left ventricular aneurysms. The study demonstrates that electrophysiologic techniques can reproduce episodes of nonsustained VT in most patients with spontaneous arrhythmias. Some patients who demonstrate only nonsustained VT spontaneously have inducible, sustained VT, most often in the setting of coronary artery disease and left ventricular aneurysms.
对83例有非持续性室性心动过速（VT）自发发作的患者进行了电生理研究。63%的患者（42例通过程控刺激，10例通过异丙肾上腺素输注）再现了临床心律失常。在15例患者中，程控刺激可重复性地诱发持续性VT。诱发性与相关心脏病有关：程控刺激在33例冠心病患者中的25例（75%）、18例心肌病患者中的6例（33%）（扩张型16例，肥厚型非梗阻性2例）、8例二尖瓣脱垂患者中的4例（50%）以及24例无结构性心脏病患者中的7例（29%）诱发了VT。异丙肾上腺素输注在其他冠心病患者中未诱发VT，在另1例二尖瓣脱垂患者、3例心肌病患者以及24例无结构性心脏病患者中的6例中诱发了VT。持续性VT仅在有结构性心脏病的患者中诱发，且与左心室室壁瘤的存在相关：13例左心室室壁瘤患者中有9例诱发了持续性VT。该研究表明，电生理技术可在大多数有自发心律失常的患者中再现非持续性VT发作。一些仅自发表现为非持续性VT的患者可诱发出持续性VT，最常见于冠心病和左心室室壁瘤的情况下。
