[Indications for electrophysiologic examination in clinical praxis]

During the past 35 years, cardiac electrophysiologic examinations have evolved into widely employed standard clinical tools in the diagnostics of different symptoms--like unexplained syncope or palpitations etc., as well as in the management of different cardiac arrhythmias. This review article presents current opinion regarding the indications and interpretations of invasive electrophysiologic examination in the bradyarrhythmias and in supraventricular and ventricular tachyarrhythmias. It is stressed that in the course of these studies, therapeutic catheter ablation procedures are being performed nowadays in many cases. Finally, the role of programmed ventricular stimulation in the risk stratification of patients with ischemic and nonischemic cardiomyopathy is discussed. It is emphasized that nonpharmacologic treatment of clinically significant brady- and tachyarrhythmias is the dominant therapeutic option at present. The dynamical progress in this field of cardiology may require periodic updating of the indications for electrophysiologic examination as well as the evaluation of their contribution to the treatment of arrhythmias and to the assessment of serious arrhythmias risk on which prophylactic therapy may be based.