Vanishing Role of EP Testing in Determining Arrhythmia Risk

For many post-MI patients, noninducibility of ventricular arrhythmias on electrophysiology testing does not mean risk is low.

Electrophysiology (EP) testing has been used both to identify patients at risk for sustained ventricular arrhythmias and to guide antiarrhythmic drug therapy. However, the value of EP testing is being reexamined in clinical trials that focus on primary prevention of sudden death. These researchers retrospectively assessed the predictive value of EP testing in the MADIT II trial, in which patients with previous MI and LV ejection fractions ≤30% had been randomized to prophylactic ICD therapy or conventional medical therapy (Journal Watch Cardiology May 3 2002) and in which prediction of arrhythmic events had been a prespecified secondary objective.

This substudy focused on the 593 ICD recipients (82% of the original ICD group) who had undergo…

Reviewing Author

Hugh Calkins, MD