El-Sherif N, Turitto G
State University of New York Science Center, Brooklyn, New York, USA.
Arch Mal Coeur Vaiss. 1996 Feb;89 Spec No 1:29-32.
Nonsustained ventricular tachycardia is not uncommon both in the presence and absence of organic heart disease and in the latter situation, is usually not associated with an increased risk. However, in patients with ischemic heart disease, especially in the post-infarction period, nonsustained ventricular tachycardia is associated with an increased risk of sudden, and possibly non-sudden, cardiac death. Several non-invasive and invasive tests have been utilized, individually or in combination, to risk stratify those patients. Left ventricular ejection fraction, the signal averaged electrocardiogram, and especially programmed ventricular stimulation have been commonly utilized to identify those patients at high risk for malignant tachyarrhythmias and to evaluate the potential benefit from antiarrhythmic treatment. At present, however, there is no consensus as to the best strategy to identify and treat high risk patients. Several ongoing multicenter clinical trials may eventually provide such guidelines. In the meantime, an algorithm for the management of those patients is suggested.
非持续性室性心动过速在有器质性心脏病和无器质性心脏病的情况下均不少见，在后一种情况下，通常与风险增加无关。然而，在缺血性心脏病患者中，尤其是在心肌梗死后时期，非持续性室性心动过速与心脏猝死以及可能的非猝死风险增加相关。已经单独或联合使用了几种非侵入性和侵入性检查来对这些患者进行危险分层。左心室射血分数、信号平均心电图，尤其是程控心室刺激，已被普遍用于识别那些发生恶性心律失常的高危患者，并评估抗心律失常治疗的潜在益处。然而，目前对于识别和治疗高危患者的最佳策略尚无共识。一些正在进行的多中心临床试验最终可能会提供此类指南。与此同时，建议采用一种针对这些患者的管理算法。
