Munger listed criteria for an abnormal electrophysiologic (EP) study in a patient with syncope.
A patient with a normal resting ECG and normal ventricular function is unlikely to have a positive electrophysiologic study.
Parameters:
(1) corrected sinus node recovery time (CSNRT)
(2) supraventricular tachycardia
(3) atrioventricular Wenckebach (AV nodal block)
(4) His-ventricular interval (interval from the onset of His bundle deflection to the onset of the ventricular deflection recorded on the His bundle electrogram or the onset of the QRS, page 706).
(5) ventricular tachycardia
(6) carotid sinus hypersensitivity
(7) head-up tilt table test
|
EP Study |
negative result |
indeterminate |
positive result |
|
CSNRT |
< 500 milliseconds |
500 - 600 milliseconds |
> 600 milliseconds |
|
supraventricular tachycardia |
none |
present with normal blood pressure |
present with hypotension |
|
atrioventricular Wenckebach |
300 - 500 milliseconds |
< 300 milliseconds |
> 500 milliseconds |
|
His-venticular interval |
35 - 55 milliseconds |
< 35 milliseconds or 55 - 100 milliseconds |
> 100 milliseconds, infra-His block |
|
ventricular tachycardia |
none |
ventricular fibrillation, polymorphic, nonsustained monomorphic |
sustained monomorphic |
|
carotid sinus hypersensitivity |
< 3 second pause |
3 - 5 second pause |
> 5 second pause, with symptoms |
|
head up tilt table test |
normal blood pressure |
asymptomatic hypotension |
hypotension with syncope |
Specialty: Cardiology
