{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T23:55:28Z","timestamp":1788393328723,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,10,5]],"date-time":"2018-10-05T00:00:00Z","timestamp":1538697600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Electrophysiology study (EPS) is an important part of the diagnosis and workup for supraventricular tachycardia (SVT). Provocative medications are used to induce arrhythmias, when they are not inducible at baseline. The most common medication is the \u03b21\u2010specific agonist, isoproterenol, but recent price increases have resulted in a shift toward the nonspecific agonist, epinephrine.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We hypothesize that isoproterenol is a better induction agent for SVT during EPS than epinephrine.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We created a retrospective cohort of 131 patients, who underwent EPS and required medication infusion with either isoproterenol or epinephrine for SVT induction. The primary outcome was arrhythmia induction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Successful induction was achieved in 71% of isoproterenol cases and 53% of epinephrine cases (<jats:italic>P<\/jats:italic>\u2009=\u20090.020). Isoproterenol was significantly better than epinephrine for SVT induction during EPS (odds ratio [OR], 2.35; 95% confidence interval [CI], 1.14\u20104.85; <jats:italic>P<\/jats:italic>\u2009=\u20090.021). There was no difference in baseline variables or complications between the two groups. Other variables associated with successful arrhythmia induction included a longer procedure duration and atrioventricular nodal re\u2010entry tachycardia as the clinical arrhythmia. In a multivariable model, isoproterenol remained significantly associated with successful induction (OR, 2.57;\u00a095% CI, 1.002\u20106.59; <jats:italic>P<\/jats:italic>\u2009=\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Isoproterenol was significantly better than epinephrine for SVT arrhythmia induction. However, epinephrine was safe and successfully induced arrhythmias in the majority of patients who received it. Furthermore, when atropine was added in epinephrine\u2010refractory cases, in a post hoc analysis there was no difference in arrhythmia induction between medications. Cost savings could thus be significant without compromising safety.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.13732","type":"journal-article","created":{"date-parts":[[2018,9,7]],"date-time":"2018-09-07T15:08:06Z","timestamp":1536332886000},"page":"1635-1640","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Arrhythmia induction using isoproterenol or epinephrine during electrophysiology study for supraventricular tachycardia"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0500-1059","authenticated-orcid":false,"given":"Parin J.","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Cardiology St Vincent Medical Group Indianapolis Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Segar","sequence":"additional","affiliation":[{"name":"Department of Cardiology St Vincent Medical Group Indianapolis Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyoti Kandlikar","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Section of Cardiology Indiana University School of Medicine Indianapolis Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benzy J.","family":"Padanilam","sequence":"additional","affiliation":[{"name":"Department of Cardiology St Vincent Medical Group Indianapolis Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric N.","family":"Prystowsky","sequence":"additional","affiliation":[{"name":"Department of Cardiology St Vincent Medical Group Indianapolis 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