Prospective comparison of a conventional and an accelerated protocol for programmed ventricular stimulation in patients with coronary artery disease.
Why the study?
Does an accelerated programmed stimulation protocol improve the efficiency and specificity of inducing monomorphic VT compared to a conventional protocol in patients with coronary artery disease and a history of VT?
Population
293 patients with coronary artery disease who had a history of sustained or nonsustained monomorphic…
Comparison
Accelerated programmed stimulation protocol vs Conventional programmed stimulation protocol
Design
Cohort
Authors
Discussion
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Implication
Accelerated protocol was associated with faster VT induction; hypothesis-generating for adoption pending randomized confirmation of specificity.
Structured PICO
Does an accelerated programmed stimulation protocol improve the efficiency and specificity of inducing monomorphic VT compared to a conventional protocol in patients with coronary artery disease and a history of VT?
P
Population
293 patients with coronary artery disease who had a history of sustained or nonsustained monomorphic ventricular tachycardia (VT)
I
Intervention
Accelerated programmed stimulation protocol (one, two, and three extrastimuli at basic drive train cycle lengths of 350, 400, and 600 msec at RV apex, repeated at second RV site)
C
Comparator
Conventional programmed stimulation protocol (one and two extrastimuli during sinus rhythm and basic drive trains at 600 and 400 msec at RV apex, then outflow tract or septum)
O
Outcome
Yield of sustained, monomorphic VT, number of protocol steps, and duration of time required to induce monomorphic VTsurrogate
An accelerated programmed ventricular stimulation protocol significantly reduces the time and steps required to induce monomorphic VT without compromising diagnostic yield compared to a conventional protocol.
Cite This Study
Morady et al. (1991) studied this question.