Ruskin J N, DiMarco J P, Garan H
N Engl J Med. 1980 Sep 11;303(11):607-13. doi: 10.1056/NEJM198009113031103.
We performed electrophysiologic studies in 31 survivors of out-of-hospital cardiac arrest not associated with acute myocardial infarction. At the time of resuscitation, eight patients had sustained ventricular tachycardia and 23 patients had ventricular fibrillation. Programmed right ventricular stimulation later revealed electrically inducible ventricular arrhythmias in 25 of the 31 patients (81 per cent). Complete suppression of electrically inducible ventricular arrhythmias was achieved with antiarrhythmic therapy in 19 of these 25 patients. None of the 19 patients in whom the inducible arrhythmias was suppressed before discharge has died suddenly or had a symptomatic arrhythmia after a mean follow-up of 15 months (range, five to 26 months). Of the six patients in whom inducible arrhythmias could not be suppressed, three died suddenly (one in the hospital) within six months. We conclude that ventricular arrhythmias can be initiated and reproduced by programmed ventricular stimulation in a majority of patients who have been resuscitated after out-of-hospital cardiac arrest and that complete suppression of these arrhythmias with anti-arrhythmic therapy is highly predictive of survival for at least one year.
我们对31例非急性心肌梗死所致院外心脏骤停的幸存者进行了电生理研究。复苏时，8例患者出现持续性室性心动过速，23例患者出现心室颤动。随后的程控右心室刺激显示，31例患者中有25例（81%）可诱发出室性心律失常。这25例患者中，19例通过抗心律失常治疗实现了可诱发性室性心律失常的完全抑制。在出院前可诱发性心律失常得到抑制的这19例患者中，平均随访15个月（5至26个月）后，无一人突然死亡或出现有症状的心律失常。在6例无法抑制可诱发性心律失常的患者中，3例在6个月内突然死亡（1例在医院内）。我们得出结论，在大多数院外心脏骤停复苏后的患者中，程控心室刺激可诱发并再现室性心律失常，并且通过抗心律失常治疗完全抑制这些心律失常对至少一年的生存具有高度预测性。
