Spielman S R, Farshidi A, Horowitz L N, Josephson M E
Am J Cardiol. 1978 Dec;42(6):913-8. doi: 10.1016/0002-9149(78)90675-6.
Ventricular fibrillation occurred in 10 (3.3 percent) of 300 patients consecutively studied with programmed ventricular stimulation. One hundred twenty-five of these patients were studied with double ventricular extrastimuli including 68 patients with and 57 patients without documented or suspected ventricular tachycardia or fibrillation, or both. Ventricular fibrillation did not develop in response to a single ventricular extrastimulus delivered during sinus rhythm, ventricular pacing or ventricular tachycardia or in response to ventricular pacing at cycle lengths of 300 msec or greater and occurred only in response to double ventricular extrastimuli. All 10 patients who manifested ventricular fibrillation during programmed stimulation were in the group of patients with suspected or documented ventricular tachycardia or fibrillation. Ventricular fibrillation was initiated in seven patients with double ventricular extrastimuli delivered during sinus rhythm or ventricular pacing and in three patients with double ventricular extrastimuli delivered during ventricular tachycardia. Four patients had spontaneous conversion to sinus rhythm and the remainder underwent defibrillation without sequelae. Recurrent ventricular fibrillation occurred clinically in 7 of the 10 patients. This study suggests that ventricular fibrillation occurs uncommonly during programmed ventricular stimulation and only in response to double ventricular extrastimuli in patients in whom spontaneous episodes are likely to occur.
在连续接受程控心室刺激研究的300例患者中，10例（3.3%）发生心室颤动。其中125例患者接受了双心室期外刺激，包括68例有记录或疑似室性心动过速或颤动，或两者皆有的患者，以及57例无上述情况的患者。在窦性心律、心室起搏或室性心动过速期间给予单个心室期外刺激时，或在周期长度为300毫秒或更长时间的心室起搏时，均未诱发心室颤动，心室颤动仅在给予双心室期外刺激时发生。在程控刺激期间出现心室颤动的所有10例患者均在疑似或有记录的室性心动过速或颤动患者组中。7例患者在窦性心律或心室起搏期间给予双心室期外刺激时诱发心室颤动，3例患者在室性心动过速期间给予双心室期外刺激时诱发心室颤动。4例患者自行转为窦性心律，其余患者接受除颤且无后遗症。10例患者中有7例临床上出现复发性心室颤动。本研究表明，心室颤动在程控心室刺激期间很少发生，且仅在可能发生自发性发作的患者中对双心室期外刺激起反应时才会出现。
