Roy D, Brugada P, Bär F W, Wellens H J
Eur Heart J. 1983 Feb;4(2):79-85. doi: 10.1093/oxfordjournals.eurheartj.a061430.
Of 110 patients without organic heart disease undergoing electrophysiological evaluation, 72 patients (65%) manifested some form of repetitive ventricular response to ventricular stimulation. In 58 (53%) bundle branch re-entry was induced and in 19 patients (17%) intraventricular re-entry. In five patients (4%) both types of repetitive responses were initiated. The indication for study was documented as ventricular tachycardia or fibrillation in 13% of the patients, supraventricular tachycardia in 51% and Wolff-Parkinson-White syndrome, syncope or conduction disturbances in the remaining patients. The incidence of clinical and inducible ventricular tachycardia or fibrillation was 8 and 2% respectively, in the group of patients manifesting only bundle branch re-entry, 37 and 32% in patients with intraventricular re-entry and 8 and 11% in patients without repetitive ventricular responses during ventricular stimulation. The predictive value of intraventricular re-entry as an indicator of severe ventricular arrhythmias was 36%. We conclude that in our population of patients without organic heart disease, bundle branch re-entry is a frequent finding and is not related to ventricular arrhythmias, that intraventricular re-entry is less frequent and although it is associated with a higher incidence of ventricular tachycardia or fibrillation, it is a poor predictor of these arrhythmias in this study population.
在110例接受电生理评估的无器质性心脏病患者中，72例（65%）对心室刺激表现出某种形式的重复性心室反应。其中58例（53%）诱发了束支折返，19例（17%）诱发了室内折返。5例（4%）引发了两种类型的重复性反应。研究的适应证记录为：13%的患者为室性心动过速或颤动，51%的患者为室上性心动过速，其余患者为预激综合征、晕厥或传导障碍。在仅表现为束支折返的患者组中，临床和诱发性室性心动过速或颤动的发生率分别为8%和2%；在有室内折返的患者中分别为37%和32%；在心室刺激期间无重复性心室反应的患者中分别为8%和11%。室内折返作为严重室性心律失常指标的预测价值为36%。我们得出结论，在我们的无器质性心脏病患者群体中，束支折返是常见的发现且与室性心律失常无关，室内折返较少见，尽管它与室性心动过速或颤动的较高发生率相关，但在本研究群体中它对这些心律失常的预测能力较差。
