Okamoto Y, Aonuma K
Cardiovascular Division, Yokosuka Kyosai General Hospital.
Nihon Rinsho. 1995 Feb;53(2):428-33.
Induction of ventricular tachycardia by programmed ventricular stimulation (PVS) is believed to be the most reliable clinical test which predicts high risk group of clinical ventricular tachycardia (VT) and sudden cardiac death (SCD) after acute myocardial infarction (MI). On the other hand, late potential (LP) detected by signal averaged electrocardiogram (SAECG) may also predict high risk group of clinical VT in MI. We compared the usefulness of these two tests. LP in SAECG could roughly predict patient group with induced sustained monomorphic VT. Moreover, PVS clearly identified non-high risk group of clinical VT or SCD which have no inducible sustained monomorphic VT with high negative predictive value. It was concluded that SAECG should be used as a screening test for life-threatening arrhythmia, and those patients who have LP should undergo PVS study to clarify the actual risk of VT and/or SCD.
通过程控心室刺激(PVS)诱发室性心动过速被认为是预测急性心肌梗死后(MI)临床室性心动过速(VT)高危组和心脏性猝死(SCD)最可靠的临床检查。另一方面,信号平均心电图(SAECG)检测到的晚电位(LP)也可能预测MI患者临床VT高危组。我们比较了这两种检查的效用。SAECG中的LP可大致预测诱发出持续性单形性VT的患者组。此外,PVS能明确识别无诱发性持续性单形性VT的临床VT或SCD低危组,其具有较高的阴性预测价值。得出的结论是,SAECG应用作危及生命心律失常的筛查检查,有LP的患者应接受PVS检查以明确VT和/或SCD的实际风险。