Electrophysiologic investigation in XXXX ; yield of programmed ventricular stimulation at two ventricular sites with up to three @entity16257 .

@entity1 @entity1789 @entity1164 @entity1165 @entity714 @entity1163 @entity16257
INTRODUCTION: Numerous reports on the inducibility of @entity1165 ( @entity1165 ) in @entity1 with atypical @entity714 and right precordial ST-elevation ( @entity1789 ) are based on multicentre studies that have used different stimulation protocols. Therefore, we prospectively investigated the inducibility of @entity1165 in these @entity1 using a uniform protocol. METHODS: In 41 consecutive @entity1 (29 males) showing a pattern of @entity714 and ST-elevation, programmed ventricular stimulation was performed in the right ventricular apex with up to three premature stimuli at sinus rhythm and at four different paced cycle lengths (500, 430, 370, and 330 ms) until refractoriness was reached or reproducible induction of a sustained (>30s) @entity1165 occurred. If a @entity1165 was not reproducibly inducible, the same protocol was repeated in the right ventricular outflow tract. RESULTS: A history of life-threatening events defined as @entity1163 (n=17) or aborted @entity1164 (n=13) was present in 30 @entity1 (73%); 11 individuals were asymptomatic. Inducibility (68%) was similar between symptomatic (n=21, 70%) and asymptomatic @entity1 (n=7, 64%). In 16 (39%) @entity1 , @entity1165 were reproducibly inducible. If @entity1 were only stimulated in the right ventricular apex, inducibility rate decreased to 39%. If only two @entity16257 at two sites were used it was as low as 32%. The mean coupling intervals of the second and third premature stimuli inducing sustained @entity1165 were short: 189+/-21 ms vs 186+/-22 ms, respectively. Forty-four percent of all @entity1 (i.e. 64% of the inducible @entity1 ) had inducible @entity1165 only with coupling intervals shorter than 200 ms. CONCLUSIONS: The stimulation protocol markedly influences the extent of inducibility of @entity1165 in @entity1 with @entity714 and ST-segment elevation. These findings question the significance of previous multicentre studies using different stimulation protocols and should have implications for further studies.
