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A Comparison of Ventricular Arrhythmias Induced with Programmed Stimulation Versus Alternating Current
Author(s) -
CUA MARK,
VELTRI ENRICO P.
Publication year - 1993
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1993.tb01598.x
Subject(s) - medicine , ventricular fibrillation , cardiology , ventricular tachycardia , defibrillation , implantable cardioverter defibrillator , defibrillation threshold , ejection fraction , tachycardia , anesthesia , heart failure
In patients undergoing implantation and testing of the implantable cardio‐verter defibrillator (ICD), alternating current (AC) may be used to induce ventricular tachyarrhythmias in a prompt, safe, and efficient manner. These arrhythmias have been previously reported to be similar to those induced during programmed electrical stimulation (PES). We compared the ventricular tachyarrhythmias induced by both methods in 14 patients: 8 male, 6 female; mean age 61 years; coronary disease in 10, cardiomyopathy in 4; mean ejection fraction 31%. The presenting arrhythmia was nonsustained ventricuiar tachycardia (VT) in four, sustained monomorphic ventricular tachycardia (SMVT) in five, ventricular fibrillation (VF) in four, and unknown in one patient with syncope. PES (single, double, triple extrastimuli; burst pacing) and AC (1–2 sec application) stimulation via right ventricular endocardial electrode catheter was performed off antiarrhythmic drugs in the nonsedated state. PES induced SMVT in nine, polymorphic VT in two, and VF in three. AC induced VF in all patients. Although AC can reliably induce ventricular tachyarrhythmias during de/ibrillation threshold and ICD testing, there is poor correlation to PES induced tachyarrhythmias.