Programmed Electrical Stimulation

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Contents 1 Indications 2 Adverse-effects 3 Procedure 4 More General Terms 5 References

Indications

• evaluation of complex

• supraventricular arrhythmias
• ventricular arrhythmias

• primarily used for catheter ablation of cardiac foci of arrhythmias, not for diagnosis [2]

Adverse-effects

• occur in about 1% of patients

Procedure

• Advantages

• the origin & mechanism of an arrhythmia can be precisely define

• Disadvantages

• invasive procedure with some risk
• time consuming & expensive
  

• In electrophysiological studies, percutaneously placed endocardial catheter electrodes are used to record intracardiac electrograms & provide PES for the evaluation of complex supraventricular & ventricular arrhythmias. In the evaluation of supraventricular arrhythmias, PES is useful in replicating the clinical arrhythmia, determining the arrhythmia mechanism, &, when appropriate, ablating the arrhythmia. Ablation procedures use radiofrequency energy to induce localized thermal injury. PES induces sustained ventricular tachycardia or fibrillation in 75% of survivors of sudden cardiac death & 95% of patients with sustained monomorphic ventricular tachycardia.
• Electrophysiologic testing includes:

• ventricular & atrial stimulation to induce arrhythmias
• testing sinus node recovery time after atrial pacing
• testing for AV nodal refractoriness

More General Terms

• electrophysiologic measurement

References

1. Manual of Medical Therapeutics, 28th ed, Ewald & McKenzie (eds), Little, Brown & Co, Boston, 1995, pg 165
2. Medical Knowledge Self Assessment Program (MKSAP) 15, American College of Physicians, Philadelphia 2009

programmed electrical stimulation (PES); electrophysiologic testing