[Value and limitations of programmed ventricular stimulation]

Area of Science:

• Cardiology
• Electrophysiology

Context:

• Electrocardiography (ECG) and prolonged ECG monitoring are standard for diagnosing most cardiac arrhythmias and guiding treatment.
• Endocavitary electrophysiological investigations are sometimes necessary for uncertain diagnoses, enhanced prognostic information, or planning interventional procedures like endocavitary ablation.

Purpose:

• To summarize the clinical utility and limitations of programmed ventricular stimulation (PVS).
• To evaluate the evolving role of PVS in cardiac arrhythmia management.

Summary:

• PVS is less frequently used for rhythm stratification due to more reliable parameters like left ventricular ejection fraction.
• However, PVS retains prognostic value in specific conditions such as arrhythmogenic right ventricular dysplasia, Brugada syndrome, and post-operative Tetralogy of Fallot.
• Strict adherence to established protocols is crucial for the validity of diagnostic and therapeutic recommendations derived from PVS studies.

Impact:

• The indications for PVS are expanding in the therapeutic domain, driven by advancements in 3D mapping and catheter guidance systems.
• These technological developments are expected to broaden the scope of endocavitary ablation procedures.
• PVS continues to be an important tool for risk stratification and guiding interventions in select cardiac arrhythmia patients.