Does Electrophysiologic Study Allow Further Risk Stratification in Survivors of Acute Myocardial Infarction?

  • R. F. E. Pedretti
  • S. Sarzi Braga
Conference paper


Several studies are now available about the possible use of electrophysiologic (EP) study in order to identify, among asymptomatic postinfarction patients, those at risk of malignant ventricular arrhythmias. Most papers clearly showed that a positive EP study represents a strong marker of subsequent life-threatening ventricular arrhythmias, supporting a possible role of programmed ventricular stimulation (PVS) in clinical practice to screen high-risk patients. Nevertheless, despite these promising results, EP testing has not been largely used in the past for risk stratification purposes, probably because EP testing is an invasive procedure and because of the lack of efficacy of antiarrhythmic drugs in preventing arrhythmic death. However, data from recent trials on the implantable cardioverter defibrillator (ICD) has refocused attention on the role of PVS in detecting patients at risk of sudden death after acute myocardial infarction (AMI). In the present paper, some of the most important studies on this topic will be reviewed in order to answer the following questions:
  1. 1.

    Among inducible ventricular arrhythmias, which is predictive of subsequent arrhythmic events?

  2. 2.

    May EP testing prognosticate independently of noninvasive testing in postinfarction patients?

  3. 3.

    May EP testing be used in both early and late postinfarction period to screen for high-risk patients?



Left Ventricular Ejection Fraction Acute Myocardial Infarction Arrhythmic Event Implantable Cardioverter Defibrillator Implantation Inducible Arrhythmia 
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Copyright information

© Springer-Verlag Italia 2000

Authors and Affiliations

  • R. F. E. Pedretti
    • 1
  • S. Sarzi Braga
    • 1
  1. 1.Divisione di Cardiologia, Clinica del Lavoro e della RiabilitazioneIRCCS Fondazione Salvatore MaugeriTradate (VA)Italy

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