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Programmed Electrical Stimulation in Mice
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Association between programmed electrical stimulation inducibility and arrhythmic risk in hypertrophic

Adil Salihu1, Panagiotis Antiochos1, Henri Lu1

  • 1Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland.

Heart (British Cardiac Society)
|April 16, 2025
PubMed

Insights

Programmed electrical stimulation (PES) can identify patients with hypertrophic cardiomyopathy (HCM) at high risk for major arrhythmic events (MAE). This study found PES inducibility is associated with a 10-fold increased risk of MAE in HCM patients.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Genetics

Background:

  • Sudden cardiac death (SCD) risk stratification in hypertrophic cardiomyopathy (HCM) is challenging.
  • Current guidelines do not endorse Programmed Electrical Stimulation (PES) for risk stratification.
  • The predictive value of PES in HCM remains debated.

Purpose of the Study:

  • To systematically review and meta-analyze the association between PES inducibility and major arrhythmic events (MAE) in HCM patients.
  • To evaluate the predictive value of PES for MAE in HCM.
  • To assess the role of PES in risk stratification for SCD in HCM.

Main Methods:

  • Systematic review and random-effects meta-analysis of five studies (587 patients).
  • Searched PubMed/MEDLINE, Embase, and Cochrane Library up to February 1, 2024.
  • Assessed MAE (SCD, cardiac arrest, ICD interventions) based on PES inducibility.

Main Results:

  • PES inducibility was found in 32% of patients.
  • MAE occurred in 18% of inducible patients versus 2% of non-inducible patients.
  • PES inducibility showed an Odds Ratio of 10.83 (95% CI 3.52 to 33.34) for MAE.

Conclusions:

  • PES inducibility significantly increases the risk of MAE in HCM patients by approximately 10-fold.
  • PES demonstrates high sensitivity (81%) and negative predictive value (98%) for MAE.
  • Further prospective studies are needed to confirm PES's independent predictive value in contemporary risk stratification.
Abstract

Keywords:
Arrhythmias, CardiacCardiomyopathy, HypertrophicElectrophysiology

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