Daily reproducibility of electrophysiologic test results in malignant ventricular arrhythmia

The reproducibility of electrophysiologic testing on successive days was assessed in the absence of antiarrhythmic drug treatment. Forty-two patients, 17 with compromising ventricular tachycardia and 25 with ventricular fibrillation unrelated to myocardial infarction, underwent 2 baseline studies. During the first electrophysiologic study, arrhythmia was induced in 32 of 42 patients (76%); however, during the second study a similar endpoint was reached in only 22 patients (52%) (chi 2 = 5.12, p less than 0.05). Only 18 of the 32 patients (56%) with induced arrhythmia during the first study had a reproducible result. Reproducibility was not related to presence of coronary artery disease, nature of presenting arrhythmia, or endpoint achieved (sustained or nonsustained ventricular tachycardia) during electrophysiologic study. Hence, reproducibility of endpoint during electrophysiologic investigation should be ascertained in each patient before initiating serial drug studies.