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PubMed · 3915709

Electrophysiologic studies for pacemaker selection.

A J Greenspon
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Abstract

Decisions regarding proper pacemaker selection are becoming increasingly complex. With the advances in pacemaker technology it is important to determine not only if permanent pacing is indicated but what type of pacemaker will be most effective. Antitachycardia pacing is becoming a more accepted treatment option in patients with disabling or life-threatening arrhythmias. With all the ongoing changes in cardiac pacing, electrophysiologic testing becomes an increasingly important and necessary tool in the evaluation of patients with complex conduction and rhythm disorders.

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Arrhythmias, CardiacAtrioventricular NodeBradycardiaCardiac Pacing, ArtificialCarotid SinusElectrocardiographyElectrophysiologyHumansPacemaker, ArtificialSinoatrial NodeSyncopeTachycardiaJournal ArticleReview

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BibTeXRIS

A J Greenspon. 1985. Electrophysiologic studies for pacemaker selection.. https://pubmed.ncbi.nlm.nih.gov/3915709/

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PubMed2000

Combined assessment of T-wave alternans and late potentials used to predict arrhythmic events after myocardial infarction. A prospective study.

OBJECTIVES: The aim of the present study was to determine whether the combination of two markers that reflect depolarization and repolarization abnormalities can predict future arrhythmic events after acute myocardial infarction (MI). BACKGROUND: Although various noninvasive markers have been used to predict arrhythmic events after MI, the positive predictive value of the markers remains low. METHODS: We prospectively assessed T-wave alternans (TWA) and late potentials (LP) by signal-averaged electrocardiogram (ECG) and ejection fraction (EF) in 102 patients with successful determination results after acute MI. The TWA was analyzed using the power-spectral method during supine bicycle exercise testing. No antiarrhythmic drugs were used during the follow-up period. The study end point was the documentation of ventricular arrhythmias. RESULTS: The TWA was present in 50 patients (49%), LP present in 21 patients (21%), and an EF <40% in 28 patients (27%). During a follow-up period of 13 +/- 6 months, symptomatic, sustained ventricular tachycardia or ventricular fibrillation occurred in 15 patients (15%). The event rates were significantly higher in patients with TWA, LP, or an abnormal EF. The sensitivity and the negative predictive value of TWA in predicting arrhythmic events were very high (93% and 98%, respectively), whereas its positive predictive value (28%) was lower than those for LP and EF. The highest positive predictive value (50%) was obtained when TWA and LP were combined. CONCLUSIONS: The combined assessment of TWA and LP was associated with a high positive predictive value for an arrhythmic event after acute MI. Therefore, it could be a useful index to identify patients at high risk of arrhythmic events.

Arrhythmias, Cardiac↗