Indications for electrophysiological investigations of tachycardia.

Cardiologists are often confronted by the situation of discussing the indic ations for invasive electrophysiological procedures. In this field, the rec ommendations of American scientific societies have been published but they are relatively dated and require updating. These procedures require the int roduction of one or more catheters by a femoral venous or arterial approach , or by the endoesophageal route for positioning at different sites in the heart, The first stage of the procedure is usually to evaluate the electrop hysiological properties of the cardiac chamber under investigation; followe d by provocative manoeuvres such as electrical stimulation, injection of a drug, the delivery of a CEE electrical shock percutaneously or by an intrac ardiac radiofrequency stimulation, according to the type of procedure or th e centre concerned. Schematically, the indications of these procedures may be determined in dif ferent contexts according to the benefits that may be expected in a given c linical situation. This article is devoted to the principal rhythmological situations which may be encountered but, however, the indications of radiof requency ablation are not discussed.