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Invasive Electrophysiologic Studies in the Evaluation and Treatment of Patients with Ventricular Arrhythmias

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Interventional Cardiology

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Abstract

Invasive electrophysiologic studies have been used in the evaluation and treatment of patients with ventricular arrhythmias since Wellens et al1 reported their initial experience in 1972. The application of this procedure to the investigation of the mechanism of sustained ventricular tachycardia has led to major advances in our understanding of this arrhythmia.2–5 A better understanding of the pathophysiologic basis of sustained uniform ventricular tachycardia has led to the development of treatment strategies, which include the use of programmed electrical stimulation to select pharmacologic agents, surgical resection, and catheter ablative techniques to destroy and/or isolate the substrate of the arrhythmia.6–9

Supported in part by grants HL00361 and HL24278 from the National Heart, Lung, and Blood Institute, Bethesda, MD, and grants from The American Heart Association, Southeastern Pennsylvania Chapter, Philadelphia, PA.

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References

  1. Wellens HJJ, Schuilenburg RM, Durrer D: Electrical stimulation of the heart in patients with ventricular tachycardia. Circulation 1972; 46:216–226.

    PubMed  CAS  Google Scholar 

  2. Josephson ME, Horowitz LN, Farshidi A, et al: Recurrent sustained ventricular tachycardia. 1. Mechanisms. Circulation 1978; 57:431–440.

    PubMed  CAS  Google Scholar 

  3. Josephson ME, Horowitz LN: Electrophysiologic approach to therapy of recurrent sustained ventricular tachycardia. Am J Cardiol 1979; 43:631–642.

    Article  PubMed  CAS  Google Scholar 

  4. Horowitz LN, Spielman SR, Greenspan AM, et al: Role of programmed stimulation in assessing vulnerability to ventricular arrhythmias. Am Heart J 1982; 103:604–610.

    Article  PubMed  CAS  Google Scholar 

  5. Josephson ME, Buxton AE, Marchlinski FE, et al: Sustained ventricular tachycardia in coronary artery disease-evidence for reentrant mechanism, in Zipes DP, Jalife J (eds): Cardiac Electrophysiology and Arrhythmias. Orlando, FL, Grune & Stratton, 1985, 409–418.

    Google Scholar 

  6. Mason JW, Winkle RA: Electrode-catheter arrhythmia induction in the selection and assessment of antiarrhythmic drug therapy for recurrent ventricular tachycardia. Circulation 1978; 58:971–985.

    PubMed  CAS  Google Scholar 

  7. Horowitz LN, Josephson ME, Farshidi A, et al: Recurrent sustained ventricular tachycardia. 3. Role of the electrophysiologic study in selection of antiarrhythmic regimens. Circulation 1978; 58:986–997.

    PubMed  CAS  Google Scholar 

  8. Josephson ME, Horowitz LN, Harken AH: Endocardial excision: A new surgical technique for the treatment of ventricular tachycardia. Circulation 1979; 60:1430–1439.

    PubMed  CAS  Google Scholar 

  9. Hartzler GO: Electrode catheter ablation of refractory focal ventricular tachycardia. J Am Coll Cardiol 1984; 2:1107–1113.

    Article  Google Scholar 

  10. Ruskin JN, DiMarco JP, Garan H: Out-of-hospital cardiac arrest: Electrophysiologic observations in selection of long-term antiarrhythmic therapy. N Engl J Med 1980; 303:607–613.

    Article  PubMed  CAS  Google Scholar 

  11. DiMarco JP, Garan H, Harthorne JW, et al: Intracardiac electrophysiologic techniques in recurrent syncope of unknown cause. Ann Intern Med 1981; 95:542–548.

    PubMed  CAS  Google Scholar 

  12. Roy D, Marchand E, Theroux P, et al: Reproducibility and significance of ventricular arrhythmias induced after an acute myocardial infarction. J Am Coll Cardiol 1986; 8:32–39.

    Article  PubMed  CAS  Google Scholar 

  13. Buxton AE, Marchlinski FE, Flores BT, et al: Nonsustained ventricular tachycardia in patients with coronary artery disease: role of electrophysiologic study. Circulation 1987; 75:1178–1185.

    Article  PubMed  CAS  Google Scholar 

  14. Josephson ME, Siedes SF: Clinical Cardiac Electrophysiologic: Techniques and Interpretations. Philadelphia, Lea & Febiger, 1979.

    Google Scholar 

  15. Gettes LS, Zipes DP, Gillette PC, et al: Personnel and equipment required for electrophysiologic testing. Circulation 1984; 69:1219A–1221A.

    PubMed  Google Scholar 

  16. Ruskin JN, Flowers NC, Josephson ME, et al: Task force VII: Arrhythmias and specialized electrophysiologic studies. J Am Coll Cardiol 1986;7:1215–1216.

    Article  PubMed  CAS  Google Scholar 

  17. DiMarco JP, Garan H, Ruskin JN: Complications in patients undergoing cardiac electrophysiologic procedures. Ann Int Med 1982; 97:490–493.

    PubMed  CAS  Google Scholar 

  18. Doherty JU, Kienzle MG, Waxman HL, et al: Programmed ventricular stimulation at a second right ventricular site: An analysis of 100 patients, with special reference to sensitivity, specificity, and characteristics of patients with induced ventricular tachycardia. Am J Cardiol 1983; 52:1184–1189.

    Article  PubMed  CAS  Google Scholar 

  19. Buxton AE, Waxman HL, Marchlinski FE, et al: Role of triple extrastimuli during electrophysiologic study of patients with documented sustained ventricular tachyarrhythmias. Circulation 1984; 69:532–540.

    Article  PubMed  CAS  Google Scholar 

  20. Gottlieb C, Josephson ME: The preference of programmed stimulation guided therapy for sustained ventricular arrhythmias, in Brugada P, Wellens HJJ (eds): Cardiac Arrhythmias: Where to go from here? Mount Kisco, NY, Futura, 1987, p 421–434.

    Google Scholar 

  21. Josephson ME, Horowitz LN, Spielman SR, et al: Role of catheter mapping in the preoperative evaluation of ventricular tachycardia. Am J Cardiol 1982; 49:207–220.

    Article  PubMed  CAS  Google Scholar 

  22. Cassidy DM, Vassallo JA, Buxton AE, et al: The value of sinus rhythm catheter mapping to localize ventricular tachycardia site of origin. Circulation 1984; 69:1103–1110.

    Article  PubMed  CAS  Google Scholar 

  23. Josephson ME, Waxman HL, Cain ME, et al: Ventricular activation during ventricular endocardial pacing. II. Role of pace mapping to localized origin of ventricular tachycardia. Am J Cardiol 1982; 50:11–22.

    Article  PubMed  CAS  Google Scholar 

  24. Miller JM, Kienzle MG, Harken AH, et al: Subendocardial resection for ventricular tachycardia. Predictors of surgical success. Circulation 1984; 70:624–631.

    Article  PubMed  CAS  Google Scholar 

  25. Josephson ME, Horowitz LN, Farshidi A, et al: Recurrent sustained ventricular tachycardia. 2. Endocardial mapping. Circulation 1978; 57:440–447.

    PubMed  CAS  Google Scholar 

  26. Josephson ME, Horowtiz LN, Spielman SR, et al: Comparison of endocardial catheter mapping with intraoperative mapping of ventricular tachycardia. Circulation 1980; 61:395–404.

    PubMed  CAS  Google Scholar 

  27. Josephson ME, Horowitz LN, Farshidi A: Continuous local electrical activity. A mechanism of recurrent ventricular tachycardia. Circulation 1978; 57:659–665.

    PubMed  CAS  Google Scholar 

  28. MacLean WAH, Plumb VJ, Waldo AL: Transient entrainment and interruption of ventricular tachycardia. PACE 1981; 4:358–366.

    PubMed  CAS  Google Scholar 

  29. Anderson KP, Swerdlow CD, Mason JW: Entrainment of ventricular tachycardia. Am J Cardiol 1984; 53:335–340.

    Article  PubMed  CAS  Google Scholar 

  30. Amendral J, Cohen M, Miller J, et al: Entrainment of ventricular tachycardia: Insights gained by electrogram recorded at the site of tachycardia origin (abstr). J Am Coll Cardiol 1985; 5:470A.

    Google Scholar 

  31. Mann DE, Lawne GM, Luck JC, et al: Importance of pacing site in entrainment of ventricular tachycardia. J Am Coll Cardiol 1985; 5:781–787.

    Article  PubMed  CAS  Google Scholar 

  32. Almendral JM, Marchlinski FE, Josephson ME: A constant first postpacing interval: New criterion for entrainment of ventricular tachycardia (abstr). Circulation 1985; 72:111–30.

    Google Scholar 

  33. Swerdlow CD, Winkle RA, Mason JW: Determinants of survival in patients with ventricular tachyarrhythmias. N Engl J Med 1983; 308:1436–1442.

    Article  PubMed  CAS  Google Scholar 

  34. Kim SG, Seiden FW, Felder SD, et al: Is programmed stimulation of value in predicting the long-term success of antiarrhythmic therapy for ventricular tachycardias? N Engl J Med 1986; 315:356–362.

    Article  PubMed  CAS  Google Scholar 

  35. Roy D, Waxman HL, Kienzle MG, et al: Clinical characteristics and long-term follow-up in 119 survivors of cardiac arrest: Relation to inducibility at electrophysiologic testing. Am J Cardiol 1983; 52:969–974.

    Article  PubMed  CAS  Google Scholar 

  36. Skale BT, Miles WM, Heger JJ, et al: Survivors of cardiac arrest: Prevention of recurrence by drug therapy as predicted by electrophysiologic testing or electrocardiographic monitoring. Am J Cardiol 1986; 57:113–119.

    Article  PubMed  CAS  Google Scholar 

  37. Graboys TB, Lown B, Podrid PJ, et al: Longterm survival of patients with malignant ventricular arrhythmia treated with antiarrhythmic drugs. Am J Cardiol 1982; 50:438–443.

    Article  Google Scholar 

  38. Waxman HL, Buxton AE, Sadowski LM, et al: The response to procainamide during electrophysiologic study for sustained ventricular tachyarrhythmias predicts the response to other medications. Circulation 1983; 67:30–37.

    Article  PubMed  CAS  Google Scholar 

  39. Waspe LE, Waxman HL, Buxton AE, et al: Mexiletine for control of drug resistant ventricular tachycardia: Clinical and electrophysiologic results in 44 patients. Am J Cardiol 1983; 51:1175–1181.

    Article  PubMed  CAS  Google Scholar 

  40. Greenspan AM, Spielman SK, Webb CR, et al: Efficacy of combination therapy with mexiletine and type IA agent for inducible ventricular tachyarrhythmias secondary to coronary artery disease. Am J Cardiol 1985; 56:277–284.

    Article  PubMed  CAS  Google Scholar 

  41. Kadish AH, Buxton AE, Waxman HL, et al: Usefulness of electrophysiologic study to determine the clinical tolerance of arrhythmia recurrences during amiodarone therapy. J Am Coll Cardiol 1987; 10:90–96.

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. Nicholas J. Stamato
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  2. Mark E. Josephson
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Editors and Affiliations

  1. Kaiser Foundation Hospital, 90027, Los Angeles, California, USA

    Amar S. Kapoor MD, FACP, FACC (Director of Cardiovascular Research, Regional Medical Director of Heart Transplant Program, Kaiser Foundation Hospital, Clinical Associate Professor of Medicine) (Director of Cardiovascular Research, Regional Medical Director of Heart Transplant Program, Kaiser Foundation Hospital, Clinical Associate Professor of Medicine)

  2. University of Southern California, 90027, Los Angeles, California, USA

    Amar S. Kapoor MD, FACP, FACC (Director of Cardiovascular Research, Regional Medical Director of Heart Transplant Program, Kaiser Foundation Hospital, Clinical Associate Professor of Medicine) (Director of Cardiovascular Research, Regional Medical Director of Heart Transplant Program, Kaiser Foundation Hospital, Clinical Associate Professor of Medicine)

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© 1989 Springer-Verlag New York Inc.

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Stamato, N.J., Josephson, M.E. (1989). Invasive Electrophysiologic Studies in the Evaluation and Treatment of Patients with Ventricular Arrhythmias. In: Kapoor, A.S. (eds) Interventional Cardiology. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-3534-7_11

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  • DOI: https://doi.org/10.1007/978-1-4612-3534-7_11

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-8145-0

  • Online ISBN: 978-1-4612-3534-7

  • eBook Packages: Springer Book Archive

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