Brembilla-Perrot B
Cardiologie A, CHU Brabois, Vandoeuvre.
Arch Mal Coeur Vaiss. 1993 May;86(5 Suppl):725-9.
Complementary investigation of ventricular tachycardia requires the use of non-invasive techniques before treatment, before considering other methods. Non-invasive investigations are usually complementary. Signal averaged electrocardiography allows detection of after potentials, a sign of a reentry circuit. Twenty-four hour Holter monitoring and exercise testing may reveal ventricular arrhythmias which could induce tachycardia. They may also show a "trigger" of tachycardia such as the catecholamine factor which is particularly sensitive to exercise testing and Holter monitoring. The latter investigation also informs on the variability of the heart rate, the disappearance of which is an argument in favour of the risk of sudden death. Holter recording and exercise testing should also be repeated after starting antiarrhythmic treatment to control the efficiency and detect possible proarrhythmogenic effects. The problem with these investigations is that they lack sensitivity as they are sometimes normal in patients with documented VT or lack specificity, ventricular arrhythmias being common and often without clinical significance.
室性心动过速的补充检查在治疗前需要先使用非侵入性技术，再考虑其他方法。非侵入性检查通常具有补充作用。信号平均心电图可检测到后电位，这是折返环路的一个迹象。24小时动态心电图监测和运动试验可能会发现可诱发心动过速的室性心律失常。它们还可能显示心动过速的“触发因素”，如对运动试验和动态心电图监测特别敏感的儿茶酚胺因素。后者的检查还能了解心率的变异性，心率变异性消失是支持猝死风险的一个论据。在开始抗心律失常治疗后，也应重复动态心电图记录和运动试验，以控制疗效并检测可能的促心律失常作用。这些检查的问题在于它们缺乏敏感性，因为在有记录的室性心动过速患者中有时结果正常，或者缺乏特异性，室性心律失常很常见且往往无临床意义。
