Esothoracic electrophysiology: a reliable pacing system for conducting the Wellens test for VT inducibility

The conventional clinical procedure in an electrophysiological study (EPS) involves transvenous catheterisation and access to X-ray fluoroscopy. Esothoracic electrophysiology (ETE) is a viable non-invasive alternative for conducting EPS without access to fluoroscopy and consequently, with more relaxed clinical environmental restrictions. The authors describe the first esothoracic pacing system capable of producing the Wellens test for ventricular tachycardia (VT) inducibility with a high degree of success. Results as presented for 12 patients comparing catheterisation and ETE show 6 patients being inducible, 4 not inducible, one false positive and one false negative