Clinical electrophysiology--a decade of progress

During the past 14 years there have been major advances in the field of clinical electrophysiology. This progress is a result of a more extensive use of intracardiac electrode catheters with recordings from multiple sites in the right and left cardiac chambers, the introduction of programmed electrical stimulation techniques and the use of antiarrhythmic drugs for diagnostic and therapeutic purposes during acute electrophysiologic testing. This article examines the pioneering studies and the subsequent developments in the field of clinical electrophysiology. The specific topics that are reviewed include the sinus node and atrium, atrioventricular conduction, supraventricular tachycardia and ventricular tachycardia. The therapeutic implications of each topic are also discussed. Clinical electrophysiology in its initial stages was a descriptive technique, but has since become an important diagnostic and therapeutic tool. However, electrophysiologic testing is an intensive process, requiring specialized training and a substantial commitment of human and physical resources.