Faculty Collaboration Database

Ultrarapid train stimulation versus conventional programmed electrical stimulation for induction of ventricular arrhythmias in patients with coronary artery disease. J Interv Card Electrophysiol 1997 Feb;1(1):15-21

Date

02/01/1997

Pubmed ID

9869946

DOI

10.1023/a:1009754432146

Scopus ID

2-s2.0-0031061106 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

Conventional programmed electrical stimulation (PES) of the ventricle is useful for establishing inducibility or noninducibility of clinical ventricular arrhythmias (VA) but is complex and time consuming. The present study was designed to compare a standard PES protocol with an alternative method using ultrarapid train stimulation in patients with VA and coronary artery disease (CAD). A prospective, randomized, crossover design was used. During each session in the electrophysiology laboratory, patients were studied using both the trains and PES protocols in randomized order. In 82 matched pairs of comparisons in 50 patients, results were concordant in 85% (p < 0.0001). There were no differences related to type of clinical arrhythmia or to the presence of antiarrhythmic drugs. There were no significant differences in the induction of nonclinical arrhythmias with the two methods (p < 0.0001 for concordance). There were no significant differences related to the cycle length of the trains (10, 20, or 30 ms, equivalent to 100, 50, or 33 Hz). The number of drive-extrastimuli sequences and the time required to complete the trains protocol was significantly shorter (p < 0.0001) using trains versus PES. Ultrarapid train stimulation provides results in CAD patients that are comparable with those of conventional PES protocols. There is a significant savings in time, adding practical value to intrinsic electrophysiologic interest. Trains may be useful when multiple inductions are desirable, for example, in the setting of antitachycardia pacing parameters in an implantable defibrillator (ICD), during ICD implantation, or in other circumstances where the main question is inducibility of ventricular arrhythmias.

Author List

Fisher JD, Cua MC, Platt SB, Waspe LE, Kim SG, Ferrick KJ, Roth JA

Author

James A. Roth MD Associate Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Arrhythmias, Cardiac
Cardiac Pacing, Artificial
Coronary Disease
Cross-Over Studies
Electric Stimulation
Female
Heart Conduction System
Humans
Male
Middle Aged
Prospective Studies