[Value and safety of ambulatory electrophysiologic study]

One-hundred-thirty patients underwent 53 electrophysiological studies including programmed atrial and ventricular stimulation and 96 atrial overdrive stimulations on an outpatient basis. The indications for electrophysiological study were disabling palpitation, syncope, or presyncope, intracardiac conduction disturbance, and bradyarrhythmia. In one patient the efficacy of oral antiarrhythmic drug therapy was evaluated by repeat electrophysiological study. Atrial overdrive stimulation was performed in patients with atrial flutter or atrial tachycardia. On the basis of the result of electrophysiological testing, 25 patients were believed not to require any treatment, 16 patients received new drug therapy, 7 patients underwent catheter ablation in a second session, 2 patients had either a pacemaker or an ICD implanted, and 1 patient continued to receive the drug therapy that had been tested. Atrial overdrive stimulation resulted in a regular sinus rhythm in 66 patients (69%). Except for one patient in whom atrial flutter could not be terminated, atrial fibrillation was induced in the remaining 30 patients. After the procedure, patients were monitored for 30 min in case of overdrive stimulation, and for approximately 3 h after electrophysiological study or 6 h if additional coronary angiography had been performed. Severe complications were not observed. In 10 cases minor hematoma occurred at the puncture site without serious sequelae.--Outpatient electrophysiological study as well as atrial overdrive stimulation are feasible and safe in a selected group of patients.