[Relation between spontaneous and electrically inducible ventricular arrhythmias in patients with coronary heart disease].
In a prospective study, 267 patients with invasively diagnosed coronary artery disease were studied by programmed electrical stimulation (PES) and induced ventricular arrhythmias were compared to spontaneous arrhythmias occurring during 24 h Holter registration. In 89 patients (33%) no evidence of myocardial infarction was present, 61 patients (23%) were studied for 6 weeks to 3 months, 36 patients (13%) for 3-6 months and 81 patients (31%) for more than 6 months after myocardial infarction. PES was performed in the right ventricular apex with 1 and 2 extrastimuli during pacing with 100, 120 and 140 beats/min. Endpoint of the study was defined by the induction of 4 repetitive ventricular responses (RVR). Within 72 hours after PES a 24 h Holter registration was performed in all patients. During PES, 15 patients (6%) were not inducible for any RVR. Single RVR (1-2) were induced in 146 patients (55%) and 3-5 RVR in 68 patients (25%). Ventricular tachycardia and ventricular fibrillation were induced in 38 patients (14%); 6 patients showed a sustained, monomorphic tachycardia. Altogether, the incidence of RVR was higher when a history of myocardial infarction was present. With increasing time after infarction the incidence of inducible 3-5 RVR remained stable; however, the number of greater than 6 RVR decreased. During Holter registration, 54/255 patients (21%) showed no spontaneous ventricular arrhythmias, 70 patients (28%) had arrhythmias of Lown-class I/II, 84 patients (33%) of Lown-class III. Complex arrhythmias were observed in 47 patients (18%) (Lown-class IVA: 33 patients, IVB: 14 patients).(ABSTRACT TRUNCATED AT 400 WORDS)
D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis*; D005117:Cardiac Complexes, Premature / Q000175:diagnosis; D002304:Cardiac Pacing, Artificial; D003327:Coronary Disease / Q000175:diagnosis*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009203:Myocardial Infarction / Q000175:diagnosis; D011379:Prognosis; D013610:Tachycardia / Q000175:diagnosis; D014693:Ventricular Fibrillation / Q000175:diagnosis
Beziehung zwischen spontanen und elektrisch induzierbaren ventrikulären Arrhythmien bei Patienten mit koronarer Herzkrankheit.