运动试验诱发室性心动过速在药物选择中的应用

EXERCISE-INDUCED VENTRICULAR TACHYCARDIA AND ITS USE FOR DRUG SELECTION

本文对24例临床有室性心动过速(VT)的患者,采用次极量蹬车运动试验结合心脏程序电刺激(PES),初步探讨了运动试验诱发VF的电生理机制。24例中有6例(25%)运动试验诱发VF,其中3例也可为PES诱发VT,另3例未能复制。结果提示,运动试验诱发VT的机制,可能是延迟后去极化触发活动和肾上腺素敏感性增高自律性异常。其中5例重复运动试验,筛选有效抗心律失常药物;β受体阻滞剂(普蒙洛尔、阿替洛尔)、维拉帕米(异搏定)及哌克昔林(沛心达)的有效率分别为4/5、3/4和2/4。

Twenty-four patients with clinical evidence of ventrieular tachycardia (VT) were studied by exercise test and programmed electrical stimulation (PES). In six of them (25%), VT were induced by exercise test. Combining with electrophysiological results, we suggest that the mechanism of inducing VT might he due to triggered activity and abnormal automaticity. Exercise tests were done repeatedly in five of the six patients for selection of antiarrhythmia drugs. The effective ratios of beta-blocker (propranolol or atenolol), verapamil and peixinda were 4/5, 3/4 and 2/4 respectively, VT became worse only in one case with verapamil.