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| 1 | Utility of electrophysiological studies to predict arrhythmic events显示文摘AIM:To evaluate the prognostic value of electrophysiological stimulation(EPS) in the risk stratification for tachyarrhythmic events and sudden cardiac death(SCD).METHODS:We conducted a prospective cohort study and analyzed the long-term follow-up of 265 consecutive patients who underwent programmed ventricular stimulation at the Luzerner Kantonsspital(Lucerne,Switzerland) between October 2003 and April 2012. Patients underwent EPS for SCD risk evaluation because of structural or functional heart disease and/or electrical conduction abnormality and/or after syncope/cardiac arrest. EPS was considered abnormal,if a sustained ventricular tachycardia(VT) was inducible. The primary endpoint of the study was SCD or,in implanted patients,adequate ICD-activation.RESULTS:During EPS,sustained VT was induced in 125 patients(47.2%) and non-sustained VT in 60 patients(22.6%); in 80 patients(30.2%) no arrhythmia could be induced. In our cohort,153 patients(57.7%) underwent ICD implantation after the EPS. During follow-up(mean duration 4.8 ± 2.3 years),a primary endpoint event occurred in 49 patients(18.5%). The area under the receiver operating characteristic curve(AUROC) was 0.593(95%CI:0.515-0.670) for a left ventricular ejection fraction(LVEF) < 35% and 0.636(95%CI:0.563-0.709) for inducible sustained VT during EPS. The AUROC of EPS was higher in the subgroup of patients with LVEF ≥ 35%(0.681,95%CI:0.578-0.785). Cox regression analysis showed that both,sustained VT during EPS(HR:2.26,95%CI:1.22-4.19,P = 0.009) and LVEF < 35%(HR:2.00,95%CI:1.13-3.54,P = 0.018) were independent predictors of primary endpoint events.CONCLUSION:EPS provides a benefit in risk stratificationfor future tachyarrhythmic events and SCD and should especially be considered in patients with LVEF ≥ 35%. | Gabriela Hilfiker Andreas W Schoenenberger Paul Erne Richard Kobza | 2015 | World Journal of Cardiology2015，7，6： | 1 |
| 2 | 扩心病患者T波电交替与心功能的关系显示文摘目的研究扩张型心肌病患者T波电交替(T-wave alternans,TWA)的发生与左室大小、射血分数等心功能状况的关系。方法 31例扩张型心肌病患者,男30例,女1例,年龄50.06±7.14(40~61)岁。对所有患者用Cambridge Heart.Heartwave TM system心脏诊断系统,以频谱法检测MTWA(Microvolt T-wave alternans,微伏级T波电交替)。对所有患者进行体检、超声心动图等检查。超声心动图测量左室舒张末内径(LVEDD)、左室射血分数(LVEF)等。分析MTWA的发生与左室大小、左室射血分数等的关系。结果扩张型心肌病MTWA阳性组的左室舒张末径大于MTWA阴性组(p<0.01),左室射血分数低于MTWA阴性组(p<0.01)。扩张型心肌病LVEDD≥65mm组MTWA阳性率高于LVEDD<65mm组(p<0.01),LVEF≤40%组MTWA阳性率高于LVEF>40%组(p<0.01)。结论扩张型心肌病患者MTWA阳性者左室末径大于阴性者,射血分数低于阴性者;左室舒张末径大(≥65mm)和/或射血分数低(≤40%)的扩张型心肌病患者MTWA阳性率高,支持TWA是一项新的判断预后指标,值得临床进一步研究。 | 王晓霞 黄织春 | 2015 | 临床心电学杂志2015，24，4： | 1 |
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