Gradman A H, Bell P A, DeBusk R F
Circulation. 1977 Jan;55(1):210-1. doi: 10.1161/01.cir.55.1.210.
A man with known coronary heart disease underwent treadmill exercise testing to determine his functional capacity. The test was negative for ischemia. Ventricular ectopic activity was noted at rest and in the recovery period. On the same day, while viewing a sporting event at home, the patient died suddenly. An ambulatory electrocardiographic recording documented ventricular fibrillations as the terminal mechanism. Ventricular ectopic activity and heart rate increased in the two hours prior to death, and ischemic ST-segment depression was noted at the time of the terminal arrhythmia. It is postulated that myocardial ischemia and catecholamine response lowered the threshold to ventricular fibrillation, thus facilitating the emergence of the fatal arrhythmia.
一名患有冠心病的男子接受了跑步机运动测试，以确定其功能能力。该测试结果显示无缺血现象。在静息期和恢复期均记录到室性异位活动。同一天，患者在家观看体育赛事时突然死亡。动态心电图记录显示心室颤动是导致死亡的最终机制。死亡前两小时室性异位活动和心率增加，在发生致命性心律失常时观察到缺血性ST段压低。据推测，心肌缺血和儿茶酚胺反应降低了心室颤动阈值，从而促使致命性心律失常的发生。
