Sudden Cardiac Death (SCD) - Electrophysiologic Studies

Dateline: 11/22/98

Have you read my previous article on SCD syndrome - Sudden Cardiac Death - Advanced Support ?

Stage 2 - Advanced electrophysiological evaluation

This makes use of a technique called Programmed Electrical Stimulation (PES). Under controlled conditions, the heart is stimulated using a preset electrical impulse in an attempt to trigger off the rhythm disorder that caused the SCD event.

If such arrhythmia can be induced ("inducible" cases), drugs are administered to try and control it. The dose of medication is adjusted until the arrhythmia can no longer be induced.

If the arrhythmia however continues to be "inducible" even after drugs, other options like surgery or implantable devices need to be considered.

If the arrhythmia cannot be induced on PES ("non-inducible" cases), other testing options like Ambulatory monitoring (where the patient has a continuous recording of EKG through the day using a Holter monitor) or Exercise testing are tried.

Again, if the arrhythmia is "inducible" using these methods, drugs are added and their dosage adjusted until the disturbance is no longer detected. Failure to respond to medications might justify surgery or device implantation.

If the arrhythmia is still not inducible, drug therapy with the potent anti-arrhythmic drug Amiodarone is started.

Recommended Reading :

The Prevention of Sudden Cardiac Death
John B. Kostis, Michael Sanders (Editor) / Published 1990
Buy it from Amazon.com. Visit the Heart Bookstore for more titles on SCD.

To learn more about Sudden Cardiac Death syndrome, read the next article in this series.