Ferrick K J, Maher M, Roth J A, Kim S G, Fisher J D
Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York 10467, USA.
Pacing Clin Electrophysiol. 1995 Jul;18(7):1395-400. doi: 10.1111/j.1540-8159.1995.tb02601.x.
Although electrophysiological studies are commonly used in the management of patients with ventricular tachycardia (VT), the reproducibility of these studies during therapy has not been established in patients in whom VT is associated with conditions other than coronary artery disease. Therefore, we performed confirmation studies during drug therapy in 60 patients (mean age 48 +/- 18 years; 41 male) with sustained ventricular arrhythmias induced during initial study to assess the reproducibility of drug effect. The stimulation protocol used included the serial introduction of up to three premature ventricular stimuli during sinus rhythm and with ventricular pacing at two pacing rates. Rapid ventricular pacing techniques were also used. Antiarrhythmic drug efficacy was confirmed in 78% of patients. Sustained VT was induced at repeat electrophysiological study in 18% of patients during antiarrhythmic therapy that had been felt to be effective on the basis of a single drug study. We conclude that electrophysiological study results during antiarrhythmic therapy exhibit significant day-to-day variability. Sustained VT can be induced during antiarrhythmic therapy previously determined to be effective by electrophysiological techniques in many patients.
尽管电生理研究常用于室性心动过速（VT）患者的治疗，但在VT与冠状动脉疾病以外的其他疾病相关的患者中，这些研究在治疗期间的可重复性尚未得到证实。因此，我们对60例（平均年龄48±18岁；41例男性）在初始研究中诱发持续性室性心律失常的患者进行了药物治疗期间的验证研究，以评估药物效果的可重复性。所使用的刺激方案包括在窦性心律期间以及以两种起搏频率进行心室起搏时连续引入多达三个室性早搏刺激。还使用了快速心室起搏技术。78%的患者抗心律失常药物疗效得到证实。在抗心律失常治疗期间，18%的患者在重复电生理研究时诱发了持续性VT，而在单一药物研究的基础上曾认为该治疗是有效的。我们得出结论，抗心律失常治疗期间的电生理研究结果表现出显著的每日变异性。在许多患者中，在先前通过电生理技术确定有效的抗心律失常治疗期间可诱发持续性VT。
