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Programmed ventricular stimulation using tandem versus simple sequential protocols

J D Fisher1, S G Kim, K J Ferrick

  • 1Department of Medicine, Montefiore Medical Center, Bronx, NY 10467.

Pacing and Clinical Electrophysiology : PACE
|March 1, 1994
PubMed
Summary
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The simple sequential ventricular stimulation protocol yields results concordant with the more complex tandem method. This finding supports using the simpler protocol to improve efficiency in electrophysiology laboratories.

Area of Science:

  • Electrophysiology
  • Cardiac Electrophysiology
  • Arrhythmia Research

Background:

  • Two programmed ventricular stimulation protocols, tandem and simple sequential, were compared.
  • The tandem method involves complex decrementing and alternating extrastimuli.
  • The simple sequential method uses stepwise decrements of extrastimuli.

Purpose of the Study:

  • To determine if two ventricular stimulation protocols produce concordant results.
  • To assess if a simpler protocol can streamline electrophysiology laboratory activities.

Main Methods:

  • Prospective, randomized, crossover, consecutive series study.
  • Both protocols tested in each patient on the same day in randomized order.
  • 84 matched studies, including baseline and drug trial data.

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Main Results:

  • 93% concordance between tandem and simple sequential protocols for arrhythmia inducibility.
  • Few, evenly distributed discordances between methods.
  • Simple sequential method was significantly faster (P < or = 0.01).

Conclusions:

  • Tandem and simple sequential protocols provide concordant results.
  • No advantage found for the more complex tandem method.
  • The simple sequential protocol is recommended for clinical use due to efficiency.