Broad applicability of ultrarapid train stimulation as an efficient alternative to conventional programmed electrical stimulation.
OBJECTIVE
Conventional programmed electrical stimulation (PES) is useful for establishing inducibility or noninducibility of clinical ventricular arrhythmias (VA), but is complex and time-consuming. This study compared a standard PES protocol with ultrarapid train stimulation (UTS) in a broad range of patients with and without a history of ventricular arrhythmias or structural heart disease.


METHODS
Patients prospectively underwent electrophysiologic testing with both UTS and conventional PES protocols in a randomized, crossover design.


RESULTS
The results were concordant in 79% of 150 matched pairs of comparisons in 104 patients (NS). There were no differences related to underlying heart disease or arrhythmia, or antiarrhythmic treatment. Induction of nonclinical arrhythmias with the two methods was similar (P = 0.524). Inhibition phenomena were minor except in some patients receiving amiodarone. Fewer drive-extrastimuli sequences and less time were needed to complete the trains protocol (P < 0.0001).


CONCLUSIONS
In cases where the main intent is to induce ventricular arrhythmias, UTS yields results that are similar to those of conventional PES protocols in a shorter length of time.
Fisher
John D
JD
Department of Medicine, Division of Cardiology, Arrhythmia Service, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, New York 10467, USA. jfisher@montefiore.org
Platt
Simie B
SB
Cua
Mark C
MC
Waspe
Lawrence E
LE
Kim
Soo G
SG
Ferrick
Kevin J
KJ
Gross
Jay N
JN
Roth
James A
JA
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D018592:Cross-Over Studies; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012032:Refractory Period, Electrophysiological; D015203:Reproducibility of Results; D017180:Tachycardia, Ventricular / Q000503:physiopathology; D014693:Ventricular Fibrillation / Q000503:physiopathology
D000889:Anti-Arrhythmia Agents