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Programmed Electrical Stimulation-Guided Pharmacotherapy

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Heart Rhythm Disorders

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Abstract

To avert spontaneous ventricular tachycardia (VT) from occurring was a challenging undertaking since VT episodes occurred sporadically and unpredictably. Thus, in the past, the few patients lucky enough to survive cardiac arrest or recurrent VT were treated with AADs. Hence, three approaches would emerge for prevention of VT and sudden cardiac death (SCD): (1) an age-old empiric approach, (2) a noninvasive approach, and (3) an invasive approach used rather extensively by American electrophysiologists. This chapter details the historical evolution of programmed ventricular stimulation (PVS) in the treatment of survivors of SCD and symptomatic VT, the limitations of PVS, and comparison of the three methods for drug testing.

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References

  1. Josephson ME, Harken AH, Horowitz LN. Endocardial excision: a new surgical technique for the treatment of recurrent ventricular tachycardia. Circulation. 1979;60:1430–9.

    CAS  PubMed  Google Scholar 

  2. Horowitz LN, Harken AH, Kastor JA, Josephson ME. Ventricular resection guided by epicardial and endocardial mapping for treatment of recurrent ventricular tachycardia. N Engl J Med. 1980;302:589–93.

    CAS  PubMed  Google Scholar 

  3. Vaughan WE. Classification of antiarrhythmic drugs. In: Sandoe E, Flensted-Jensen E, Olsen K, editors. Symposium on cardiac arrhythmias. Elsinore: Astra; 1970. p. 826.

    Google Scholar 

  4. Vaughan Williams EM. A classification of antiarrhythmic actions reassessed after a decade of new drugs. J Clin Pharmacol. 1984;24:129–47.

    CAS  PubMed  Google Scholar 

  5. Wellens HJJ, et al. Electrical stimulation of the heart in patients with ventricular tachycardia. Circulation. 1972;38:216–26.

    Google Scholar 

  6. Graboys TB, Lown B, Podrid PJ, DeSilva R. Long-term survival of patients with malignant ventricular arrhythmia treated with antiarrhythmic drugs. Am J Cardiol. 1982;50:437–43.

    CAS  PubMed  Google Scholar 

  7. Lown B, Wolf M. Approaches to sudden death from coronary artery disease. Circulation. 1971;44:130–42.

    CAS  PubMed  Google Scholar 

  8. Fisher JD, Cohen HL, Mehra R, et al. Cardiac pacing and pacemakers, II. Serial electrophysiologic-pharmacologic testing for control of recurrent tachyarrhythmias. Am Heart J. 1977;93:658–68.

    CAS  PubMed  Google Scholar 

  9. Josephson ME, Horowitz LN, Farshidl A, Kastor JA. Recurrent sustamed ventricular tachycardia I. Mechanisms. Circulation. 1978;57:440–7.

    CAS  PubMed  Google Scholar 

  10. Gomes JAC, Kang PS, et al. The repetitive ventricular responses: its incidence, inducibility, reproducibility, mechanism and significance. Br Heart J. 1981;46:159–67.

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Buxton AE, Waxman HL, Marchlinskl FE, Untereker WJ, Waspe LE, Josephson ME. Role of triple extrastimuli during electrophysiologic study of patients with documented sustained ventricular tachyarrhythmias. Circulation. 1984;69:532–40.

    CAS  PubMed  Google Scholar 

  12. Morady F, Di Carlo L, Winston S, Davis JC, Scheiman MM. A prospective comparison of triple extrastimuli and left ventricular stimulation in studies of ventricular tachycardia induction. Circulation. 1984;70:52–7.

    CAS  PubMed  Google Scholar 

  13. Kudenchuk PJ, Kron J, Walance C, et al. Reproducibility of arrhythmia induction with intracardiac electrophysiology testing: patients with clinical sustained ventricular tachyarrhythmias. J Am Coll Cardiol. 1986;7:819–28.

    CAS  PubMed  Google Scholar 

  14. Waxman HL, et al. The response to procainamide during electrophysiological study for sustained ventricular tachyarrhythmias predicts the response to other medications. Circulation. 1983;67:30–7.

    CAS  PubMed  Google Scholar 

  15. Fisher JD, Krikler D, Hallidie-Smith KA. Familial polymorphic ventricular arrhythmias: a quarter century of successful medical treatment based on serial exercise-pharmacologic testing. JACC. 1999;34:2015–22.

    CAS  PubMed  Google Scholar 

  16. Mehra R, Furman S, Crump JF. Vulnerability of the mildly ischemic ventricle to cathodal, nodal, and bipolar stimulation. Circ Res. 1977;41:159–66.

    CAS  PubMed  Google Scholar 

  17. Fisher JD, Kim SG, Ferrick KJ, Artoul SG, Fink D, Roth JA, Johnston DR, Williams HR. Programmed electrical stimulation of the ventricle, an efficient, sensitive and specific protocol. PACE. 1992;15:435–50.

    CAS  PubMed  Google Scholar 

  18. Fisher JD, Kim SG, Ferrick KJ, Roth JA. Programmed ventricular stimulation using tandem vs simple sequential protocols. PACE. 1994;17:286–94.

    CAS  PubMed  Google Scholar 

  19. Fisher JD, Platt SB, Cua MC, Waspe LE, Kim SG, Ferrick KJ, Roth JA. Ultrarapid train stimulation: an efficient alternative to conventional programmed electrical stimulation for induction of ventricular arrhythmias. J Interv Card Electrophysiol. 1997;1:15–21.

    CAS  PubMed  Google Scholar 

  20. Fisher JD, Mehra R, Furman S. Termination of ventricular tachycardia with bursts of rapid ventricular pacing. Am J Cardiol. 1978;41:94–102.

    CAS  PubMed  Google Scholar 

  21. Fisher JD, Kim SG, Matos JA, Ostrow E. Comparative effectiveness of pacing techniques for termination of well-tolerated sustained ventricular tachycardia. PACE. 1983;6:915–22.

    CAS  PubMed  Google Scholar 

  22. J. Anthony Gomes. Inducibility and reproducibility of ventricular arrhythmias: therapeutic implications. J Am Coll Cardiol. 1986;7(4):829–31.

    Google Scholar 

  23. Vandepol CJ, Farshidi A, Spielman SR, Greenspan AM, Horowitz LN, Josephson ME. Incidence and clinical significance of induced ventricular tachycardia. Am J Cardiol. 1980;45:725–31.

    CAS  PubMed  Google Scholar 

  24. Brugada P, Green M, Abdollah H, HJJ W. Significance of ventricular arrhythmias induced by programmed electrical stimulation. The importance of the type of ventricular arrhythmias induced and the number of premature stimuli required. Circulation. 1984;69:87–92.

    CAS  PubMed  Google Scholar 

  25. Schoenfield MH, McGovern B, Garan H, Kelly E, Grant G, Ruskin IN. Determinants of the outcome of electrophysiologic study m patients with ventricular arrhythmias. J Am Coll Cardiol. 1985;6:298–306.

    Google Scholar 

  26. Denniss AR, Richards DA, Cody DV, et al. Prognostic significance of ventricular tachycardia and fibrillation induced at programmed stimulation and delayed potentials detected on the signal-averaged electrocardiograms of survivors of acute myocardial infarction. Circulation. 1986;74:731–45.

    CAS  PubMed  Google Scholar 

  27. Richards D, Taylor A, Fahey P, et al. Identification of patients at risk of sudden death after myocardial infarction: the continued Australian experience. In: Brugada P, Wellens HJJ, editors. Cardiac arrhythmias: where to go from here? Mount Kisco: Futura Publishing; 1987. p. 329–41.

    Google Scholar 

  28. Roy D, Marchand E, Theroux P, Waters DD, Pelletier GB, Bourassa MG. Programmed ventricular stimulation in survivors of an acute myocardial infarction. Circulation. 1985;72:487–94.

    CAS  PubMed  Google Scholar 

  29. Gomes JAC, Hariman RI, Kang PS, El-Sherif N, Chowdhry I, Lyons J. Programmed electrical stimulation in patients with high-grade ventricular ectopy: electrophysiologic findings and prognosis for survival. Circulation. 1984;70:43–51.

    CAS  PubMed  Google Scholar 

  30. Buxton AE, Marchlinski FE, Flores BT, Miller JM, Doherty JU, Josephson ME. Nonsustained ventricular tachyarrhythmia in patients with coronary artery disease: role of electrophysiologic study. Circulation. 1987;75:1178–18.

    CAS  PubMed  Google Scholar 

  31. Klein RC, Machell C. Use of electrophysiologic testing in patients with nonsustained ventricular tachycardia: prognostic and therapeutic implications. J Am Coll Cardiol. 1989;14:155–61.

    CAS  PubMed  Google Scholar 

  32. Wilber DJ, Olshansky B, Moran JF, Scanlon PJ. Electrophysiological testing and nonsustained ventricular tachycardia: use and limitations in patients with coronary artery disease and impaired ventricular function. Circulation. 1990;82:350–3.

    CAS  PubMed  Google Scholar 

  33. Buxton AE, Lee KL, Fisher JD, et al. A randomized study of the prevention of sudden cardiac death in patients with coronary artery disease. N Eng J Med. 1999;3421:1882–90.

    Google Scholar 

  34. Mossi AR, Goldstein S, Vander S, Medendorp B, et al. Effect of empiric antiarrhythmic therapy in resuscitated out-of-hospital cardiac arrest victims with coronary artery disease. Am J Cardiol. 1990;65:1192–7.

    Google Scholar 

  35. Josephson ME, Horowitz LN. Electrophysiologic approach to therapy of recurrent sustained ventricular tachycardia. Am J Cardiol. 1979;43:631–42.

    CAS  PubMed  Google Scholar 

  36. Horowitz LN, Josephson ME, Spielman AR, Michelson EL, Greenspan AM. Recurrent sustained ventricular tachycardia 3. Role of electrophysiologic study in selection of antiarrhythmic regimens. Circulation. 1978;57(6):986–97.

    Google Scholar 

  37. Denes P, Wyndham CR, Dhingra RC, Amat-y-Leon F, Wyndham C, Mautner RF, Rosen KM. Electrophysiologic studies in patients with chronic recurrent ventricular tachycardia. Circulation. 1976;54:229.

    CAS  PubMed  Google Scholar 

  38. Hartzler GO, Maloney JD. Programmed ventricular stimulation in management of recurrent ventricular tachycardia. Mayo Clin Proc. 1977;52:731.

    CAS  PubMed  Google Scholar 

  39. Ruskin JN, DiMarco JP, Garan H. Out-of-hospital cardiac arrest — electrophysiologic observations and selection of long-term antiarrhythmic therapy. N Engl J Med. 1980;303:607–13.

    CAS  PubMed  Google Scholar 

  40. Wilber DJ, Garan H, Finkelstein D, et al. Out-of-hospital cardiac arrest. Use of electrophysiological testing in the prediction of long-term outcome. N Engl J Med. 1988;318:19–24.

    CAS  PubMed  Google Scholar 

  41. Swerdlow CD, Echt DS, Winkle RA, Ross DL, Griffin JC, Mason JW. Determinants of survival in patients with ventricular tachyarrhythmias. N Engl J Med. 1983;308:1436–7.

    CAS  PubMed  Google Scholar 

  42. Mason JW for the Electrophysiologic Study Versus Electrocardiographic Monitoring Investigators. A comparison of electrophysiologic testing with Holter monitoring to predict antiarrhythmic-drug efficacy for ventricular tachyarrhythmias. N Engl J Med. 1993;329:445–51.

    Google Scholar 

  43. Echt DS, Lierson PR, Mitchell LB, et al. Mortality and morbidity in patients receiving encainide, flecainide, or placebo: the cardiac arrhythmia suppression trial. N Engl J Med. 1991;324(12):781–8.

    CAS  PubMed  Google Scholar 

  44. Herre JM, Suave MJ, Malone P, et al. Long-term results of amiodarone therapy in patients with recurrent sustained ventricular tachycardia or ventricular fibrillation. J Am Coll Cardiol. 1989;13(2):442–9.

    CAS  PubMed  Google Scholar 

  45. Fisher JD. Role of electrophysiologic testing in the diagnosis and treatment of patients with known and suspected bradycardias and tachycardias. Prog Cardiovasc Dis. 1981;24:25–90.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Icahn School of Medicine, Mount Sinai Hospital, New York, NY, USA

    J. Anthony Gomes

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Gomes, J.A. (2020). Programmed Electrical Stimulation-Guided Pharmacotherapy. In: Heart Rhythm Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-45066-3_23

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  • DOI: https://doi.org/10.1007/978-3-030-45066-3_23

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-45065-6

  • Online ISBN: 978-3-030-45066-3

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