[Who should be referred for electrophysiologic studies?].
Prerequisite of a rational antiarrhythmic therapy is the correct diagnosis of the given cardiac rhythm disorder. The majority of intermittent and latent cardiac arrhythmias can be reliably induced and analyzed during the electrophysiologic study (EPS). In case of bradyarrhythmias, the method is indicated in patients with suspected sinus node disease or high-grade AV conduction disturbances, as far as the cause of clinical symptoms cannot be settled by Holter recordings. Since patients with paroxysmal supraventricular tachycardias (WPW syndrome and AV nodal reentrant tachycardia) can be cured by transvenous ablation techniques, EPS is indicating in this setting in all symptomatic patients for the diagnosis and the treatment of the given arrhythmia. In patients with recurrent ventricular tachyarrhythmias, EPS should be performed to establish the diagnosis and to control medical treatment; in addition, EPS is a prerequisite for nonpharmacologic treatment modalities such as defibrillator therapy and transvenous or surgical ablation techniques. In survivors of cardiac arrest without new Q-wave myocardial infarction, persistent ventricular tachyarrhythmias can be induced in some 50% of the patients. Patients should be evaluated by EPS in case the reasons for significant clinical symptoms cannot be determined otherwise, given the likelihood, that brady- or tachyarrhythmias are the cause of the clinical symptoms; this includes patients with organic heart disease and with unexplained syncopes.
Manz
M
M
Innere Medizin, Kardiologie, Medizinische Universitätsklinik Bonn.
Jung
W
W
Lüderitz
B
B
D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000503:physiopathology; D002304:Cardiac Pacing, Artificial; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000295:instrumentation*; D006329:Heart Conduction System / Q000503:physiopathology; D006801:Humans; D010348:Patient Care Team; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation*
Wer muss zur elektrophysiologischen Studie überwiesen werden?