Broad applicability of ultrarapid train stimulation as an efficient alternative to conventional programmed electrical stimulation

Background and study objective: Conventional programmed electrical stimulation (PES) is useful for establishing inducibility or noninducibility of clinical ventriculur arrhythmius (VA), but is complex and time-consuming. This study compared a standard PES protocol with ultrarapid train stimulation (UTS) in a broad range of patients with and without a history of ventricular arrhythmias or structural heart disease. Methods: Patients prospectively underwent electrophysiologic testing with both UTS and conventional PES protocols in a randomized, crossover design. Results: The results were concordant in 79% of 150 matched pairs of comparisons in I04 patients (NS). There were no differences related to underlying heart disease or arrhythmia, or antiarrhythmic treatment. Induction of nonclinical arrhythmias with the two methods was similar (P = 0.524). Inhibition phenomena were minor except in some patients receiving amiodarone. Fewer drive-extrastimuli sequences and less time were needed to complete the trains protocol (P < 0.0001). Conclusions: In cases where the main intent is to induce ventriculur arrhythmias, UTS yields results that are similar to those of conventional PES protocols in a shorter length of time.