Predictive Value of Various Types of Ventricular Response to Programmed Ventricular Stimulation: Relation to Holter Monitoring

The study was performed to determine the predictive value of programmed stimulation for identification of pts with ventricular arrhythmias: 75 patients were studied by means of 24-hour ambulatory ECG (24 ECG) and programmed right (in some patients also left) ventricle stimulation at sinus and two or three pacing rates using two (standard) and three extrastimuli or burst stimulation (extensive protocol). Lown classes 0.1–3 and 4a–4h were observed in 24 ECG in 35, 14, and 26 patients, respectively. In programmed stimulation 1–6 repetitive ventricular responses (RVR) were found in 56 pts, nonsustained ventricular tachycardia in 11 and sustained ventricular tachycardia in 21 pts. High incidence of induced VT was found in pts with complex ventricular arrhythmia in 24 ECG, 81% of this group, in all but six pts only standard protocol was used. The 1–6 RVR were observed in almost 40% of pts without any arrhythmia. Conclusion; Only VT induction is a useful index for high risk patients.