Brembilla-Perrot B, Jacquemin L, Houriez P, Houplon P, Claudon O, Beurrier D, Terrier de la Chaise A, Louis P
Service de cardiologie A, CHU Brabois, Vandoeuvre-lès-Nancy.
Arch Mal Coeur Vaiss. 1998 Mar;91(3):301-7.
The reproducibility of programmed ventricular stimulation has been previously demonstrated for periods of a few hours to several months. It has not been studied over longer intervals. The aim of this study was to assess the reproducibility of the method at long-term (> 2 years). Forty-six patients with underlying cardiac disease underwent two programmed ventricular stimulations in the absence of antiarrhythmic treatment at intervals of 2 to 6 years (mean 4 years). None of the patients had myocardial infarction or cardiac surgery during this period. The protocol was identical: up to 3 extra-stimuli were delivered in the two right ventricular sites over 3 cycles. Twenty-eight patients had inducible sustained monomorphic ventricular tachycardia during the first investigation (Group I): the investigation was negative in the remaining 18 patients (Group II). During the second investigation, 26 of the 28 patients in Group I had inducible ventricular tachycardia, the rate of which decreased from 206 +/- 50 bpm to 196 +/- 54 bpm. The induced ventricular tachycardia was slower in 15 patients and faster in 5 patients. The mode of induction was different in 12 cases. In Group II, 4 patients (22%) had inducible sustained ventricular tachycardia at the second investigation. The authors conclude that the reproducibility of programmed ventricular stimulation remains good in the long-term in subjects within inducible tachycardia, demonstrating the stability of the arrhythmogenic substrate; the frequency of this tachycardia is generally slower. In subjects with an abnormal initial investigation who became symptomatic, it may be useful to repeat programmed ventricular stimulation.
既往已证实程控心室刺激在数小时至数月期间具有可重复性,但尚未对更长时间间隔进行研究。本研究的目的是评估该方法在长期(>2年)的可重复性。46例患有基础心脏病的患者在未接受抗心律失常治疗的情况下,间隔2至6年(平均4年)接受了两次程控心室刺激。在此期间,所有患者均未发生心肌梗死或接受心脏手术。方案相同:在3个心动周期内,在两个右心室部位发放多达3个额外刺激。在首次检查时,28例患者可诱发出持续性单形性室性心动过速(I组),其余18例患者检查结果为阴性(II组)。在第二次检查时,I组28例患者中有26例可诱发出室性心动过速,其频率从206±50次/分降至196±54次/分。15例患者诱发出的室性心动过速较慢,5例患者较快。12例患者的诱发方式不同。在II组中,4例患者(22%)在第二次检查时可诱发出持续性室性心动过速。作者得出结论,对于可诱发出心动过速的受试者,程控心室刺激的长期可重复性仍然良好,表明致心律失常基质稳定;这种心动过速的频率通常较慢。对于初始检查异常且出现症状的受试者,重复进行程控心室刺激可能有用。