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This article summarises the potential role of invasive electrophysiological studies (EPS) for the risk stratification and management of inherited channelopathies and cardiomyopathies based on the latest clinical evidence as well as published clinical guidelines, including the American College of Cardiology/American Heart Association guidelines and the Heart Rhythm UK 2010 position statement. Generally speaking, there is no role for EPS and genetic studies in the diagnosis and risk stratification of hereditary channelopathies. Nevertheless, the controversy over the role of EPS in asymptomatic Brugada syndrome remains. In the case of inherited cardiomyopathies, there is no role for invasive EPS in symptomatic patients with hypertrophic cardiomyopathy (HCM) and atherosclerotic renovascular disease (ARVD). On the other hand, in patients with suspected HCM or AVRD, a negative EPS might be helpful in identifying the population at low risk of sudden cardiac death.

Inherited Channelopathies and Cardiomyopathies – When Is Invasive Risk Stratification Needed?