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Effect of repetition of extrastimuli on sensitivity and reproducibility of mode of induction of ventricular tachycardia by programmed stimulation.

Abstract：

:This study examined the effect of repeating the delivery of a programmed extrastimulus that previously failed to induce ventricular tachycardia, without the usual practice of concurrently altering other stimulation variables such as pacing site or basic cycle length. The impact of such repetition on both sensitivity and day to day variability in mode of arrhythmia induction was assessed in 24 patients with documented sustained ventricular tachycardia or fibrillation. Programmed stimulation in the absence of drugs was performed in each patient on 3 separate days. In the first 12 patients, each extrastimulus was scanned through diastole to refractoriness four times if no ventricular tachyarrhythmia was induced (longitudinal repetition); in the second 12 patients, each extrastimulus was delivered four times at a particular coupling interval before the interval was decreased in 10 ms steps to a closer coupling interval (lateral repetition). Day to day reproducibility of the mode of arrhythmia induction was compared with reproducibility in a control group of 18 similar patients studied previously on 3 separate days without repetition. A sustained ventricular tachyarrhythmia was inducible in all studies with four or fewer extrastimuli. In the group studied with longitudinal repetition, there was a 25% increased yield of induced ventricular tachycardia due solely to repetition of each extrastimulus scan, and the 95% confidence limit for tachycardia induction with any extrastimulus was achieved by delivering that extrastimulus three times. In the group studied with lateral repetition, there was also an increased yield of induced ventricular tachycardia at any extrastimulus coupling interval achieved by repetitive delivery of that coupling interval.(ABSTRACT TRUNCATED AT 250 WORDS)

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Cooper MJ,Hunt LJ,Richards DA,Denniss AR,Uther JB,Ross DL

doi

10.1016/0735-1097(88)90290-2

subject

Has Abstract

pub_date

1988-06-01 00:00:00

pages

1260-7

issue

eissn

0735-1097

issn

1558-3597

pii

0735-1097(88)90290-2

journal_volume

pub_type

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Effect of repetition of extrastimuli on sensitivity and reproducibility of mode of induction of ventricular tachycardia by programmed stimulation.