Sra J, Underwood R D, Akhtar M
Electrophysiology Laboratory, Milwaukee Heart Institute of Sinai Samaritan Medical Center, Milwaukee, USA.
Indian Heart J. 1995 Mar-Apr;47(2):158-62.
Over 50 percent of deaths in patients who survive an acute myocardial infarction (MI) are due to fatal ventricular tachyarrhythmias. Patients who survive an episode of sustained ventricular arrhythmia are at highest risk of recurrent cardiac arrest. Electrophysiological studies have been found to be useful in guiding therapy and reducing mortality in these patients. However, evaluation and treatment of nonsustained ventricular tachycardia following MI remains controversial. Asymptomatic patients at high risk after MI include those who have significant left ventricular dysfunction, positive late potentials on signal-averaged electrocardiogram (SAECG), high grade ventricular ectopy and abnormal heart rate variability. These tests, however, have a low positive predictive accuracy and are not helpful to guide therapy with antiarrhythmic drugs which are usually ineffective and can frequently harm these patients. Beta-adrenoreceptor blocking agents, however, have been shown to reduce mortality after an acute myocardial infarction.
在急性心肌梗死（MI）后存活的患者中，超过50%的死亡是由致命性室性心律失常所致。经历过持续性室性心律失常发作且存活的患者发生心脏骤停复发的风险最高。已发现电生理研究有助于指导这些患者的治疗并降低死亡率。然而，心肌梗死后非持续性室性心动过速的评估和治疗仍存在争议。心肌梗死后高危无症状患者包括那些有显著左心室功能障碍、信号平均心电图（SAECG）上晚期电位阳性、高级别室性早搏及心率变异性异常的患者。然而，这些检查的阳性预测准确性较低，无助于指导抗心律失常药物治疗，而这类药物通常无效且常常对这些患者有害。然而，β肾上腺素能受体阻滞剂已被证明可降低急性心肌梗死后的死亡率。
