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.



(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


positive result


< 500 milliseconds

500 - 600 milliseconds

> 600 milliseconds

supraventricular tachycardia


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


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


To read more or access our algorithms and calculators, please log in or register.