When and How: Electrophysiological Study (EPS)
The gold standard for diagnosis of arrhythmia-induced syncope is correlation of abnormal ECG findings of spontaneous cardiac arrhythmias with symptoms (i.e., syncope). Obtaining such documentation is usually best achieved by ambulatory electrocardiographic (ECG) recording (e.g., “Holter” monitors, “event” recorders, mobile cardiac outpatient telemetry (MCOT), or insertable loop recorders (ILRs)). However, in many patients it may not be possible to obtain such documentation due to the infrequency of symptomatic events, or concerns regarding patient safety should a spontaneous recurrence be associated with a life-threatening circumstance or potential for physical injury. In such cases, electrophysiological study (EPS) may be warranted in an attempt to obtain at least a plausible cause for the symptoms. This is particularly the case in those individuals with an abnormal ECG and/or evidence underlying structural heart disease.
KeywordsSinus Node Structural Heart Disease Brugada Syndrome Sinus Node Dysfunction Paroxysmal Supraventricular Tachycardia
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