Comparison of endocardial and epicardial programmed stimulation for the induction of ventricular tachycardia

Twenty-seven patients who had pairs of stainless steel wire electrodes placed on the right and the left ventricle during cardiac surgery underwent both epicardial and endocardial programmed ventricular stimulation to assess the inducibility of ventricular tachycardia. Twenty-six of the patients had...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 1989-06, Vol.13 (7), p.1608-1612
Main Authors: Dailey, Sharon M., Neal Kay, G., Epstein, Andrew E., McGiffin, David C., Kirklin, James K., Plumb, Vance J.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Cardiac dysrhythmias
Cardiac Pacing, Artificial - methods
Cardiology. Vascular system
Electrocardiography
Electrodes, Implanted
Electrophysiology
Endocardium
Follow-Up Studies
Heart
Heart Conduction System - physiopathology
Humans
Medical sciences
Pericardium
Postoperative Care - methods
Stainless Steel
Tachycardia - etiology
Tachycardia - physiopathology
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Summary:Twenty-seven patients who had pairs of stainless steel wire electrodes placed on the right and the left ventricle during cardiac surgery underwent both epicardial and endocardial programmed ventricular stimulation to assess the inducibility of ventricular tachycardia. Twenty-six of the patients had coronary artery disease and were studied to evaluate map-guided surgery for treatment of ventricular arrhythmias. Burst ventricular pacing and up to three ventricular extrastimuli coupled to two drive train cycle lengths were delivered from the right and left ventricular epicardial wire electrodes and from endocardial catheter electrodes placed at the apex and outflow tract of the right ventricle. Ventricular tachycardia was reproducibly induced in three patients by both endocardial and epicardial stimulation. In one patient ventricular tachycardia was reproducibly induced by epicardial stimulation, but nonreproducible, nonsustained ventricular tachycardia was induced by endocardial stimulation. Ventricular tachycardia remained inducible by both endocardial and epicardial stimulation in three instances (two patients) during drug therapy. A negative study (
ISSN:0735-1097
1558-3597
DOI:10.1016/0735-1097(89)90355-0