PMID: 8582387Sep 1, 1995Paper

Comparison of the results of programmed ventricular stimulation from the right ventricular apex and outflow tract: a randomized, prospective study

European Heart Journal
A Martínez-RubioG Breithardt

Abstract

The aim of this prospective study was to analyse the yield of programmed ventricular stimulation at the right ventricular apex compared with the outflow tract. A stepwise randomized cross-over protocol of programmed ventricular stimulation with alternating stimulation at both sites was used in 66 patients who were studied because of sustained ventricular tachycardia (n = 30), ventricular fibrillation (n = 7), or non-sustained ventricular tachycardia and/or syncope (n = 29). There were no significant differences between the results of stimulation from either right ventricular site with regard to the presence or absence of structural heart disease, spontaneous arrhythmia, ejection fraction or effective refractory periods. Overall, monomorphic ventricular tachycardia was inducible in 33 patients (50%); in 25 patients (75.8%), this arrhythmia was induced from both sites. However, in only 17 of these 25 patients (68%) did the induced monomorphic ventricular tachycardias have the same morphologies and similar (+/- 50 ms) cycle lengths. Ventricular fibrillation was inducible in 11 patients (17%), mostly by three extrastimuli (n = 8; 73%). (1) stimulation from at least two right ventricular sites is desirable because of their independe...Continue Reading

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