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European Heart Journal 1989 10(Supplement E):61-65; doi:10.1093/eurheartj/10.suppl_E.61
Copyright © 1989 by the European Society of Cardiology.
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© 1989 The European Society of Cardiology

Control of antiarrhythmic drug therapy by electrophysiologic testing

G. Steinbeck*,, B. Lüderitz{dagger} and D. Andresen{ddagger}

* Medizinische Klinik I, Universität München München, Bonn
{dagger} Medizinische Universitätsklinik Bonn Innere Medizin—Kardiologie, Bonn
{ddagger} Abteilung Kardiologie der Freien Universität Berlin Klinikum Steglitz, Berlin, F.R.G.

Address for correspondence: G. Steinbeck, Medizinische Klinik I, Universität München, München, Federal Republic of Germany

Pioneering electrophysiological studies in the 1970s by Wellens and Josephson showed that in the majority of patients who have survivedan episode of sustained ventricular tachycardia, the arrhythmia can be initiatedand terminated by programmed electrical stimulation in the catheterization laboratory. Later work demonstrated that this method can also be applied to patients who have survived an episode of cardiac arrest due to ventricular fibrillation, not associated with acute myocardial infarction. As a consequence, serial electrophysiologic testing can be recommended to assess the eficacy of antiarrhythmic agents for the guidance of long-term treatment of these patients. This report focuses on some aspects of this method such as the recommended indications at present, differences in the electrophysiologic protocols among various authors, the results to be obtained by serial electrophysiologic testing, and finally discusses the question—not yet resolved—whether an improvement of outcome can thereby be achieved.

Key Words: Programmed ventricular stimulation • ventricular tachycardia • antiarrhythmic drugs


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