What Are Programmed Stimulation and Entrainment Techniques?

These techniques help to gather information about the conduction system of the heart, which can further be used to guide the treatment of heart rhythm disorders (arrhythmias).

Programmed stimulation and entrainment techniques are methods of setting the rhythm and rate of the heart. These techniques help to gather information about the conduction system of the heart, which can further be used to guide the treatment of heart rhythm disorders (arrhythmias).

The heart has its internal electrical system to control the rate and rhythm of the heartbeat. During a heartbeat, the different chambers of the heart receive electrical impulses from the heart’s natural pacemaker (the sinoatrial [SA] node) that causes phasic contraction and relaxation of different parts of the heart. The normal heartbeat allows the heart to pump blood regularly and adequately to meet the body’s requirement. Faulty electrical signals in the heart lead to arrhythmias. This may cause the heart to beat too fast (tachycardia), too slow (bradycardia), or with an irregular rhythm. An arrhythmia may hamper the ability of the heart to pump blood effectively leading to symptoms such as:

• Fatigue
• Fainting
• Breathlessness
• Uneasiness
• Chest pain
• Sweating

There are several types of arrhythmias, and although their symptoms may be overlapping, each arrhythmia has a different source, cause, and treatment strategy. Programmed stimulation and entrainment techniques help in reaching to the cause of arrhythmia and accordingly help the doctor plan an appropriate management strategy.

Programmed stimulation and entrainment are used to evaluate the following conditions:

• Tachycardia (heart rate more than normal)
• Syncope (fainting episodes caused by a decrease in blood pressure) in patients with structural heart disease (wear and tear in the heart due to conditions such as aging, high blood pressure, and heart attack)
• Risk of sudden death in patients with a history of heart attack
• The success of a ventricular tachycardia treatment
• Arrhythmias (such as ventricular tachycardia, supraventricular tachycardia, and bradyarrhythmias)
• Efficacy of an antiarrhythmic drug therapy
• Cardiomyopathy (disease of the heart muscles)

• To prepare you for the procedure, your doctor will familiarize you with the procedure and the possible complications, including those related to the sedation given for the procedure.
• You will be made aware of the requirement for bed rest after the procedure is performed.
• You will be provided with written home-care instructions as well.
• You will be asked

Programmed stimulation and entrainment procedures are safely performed on a conscious patient under intravenous (IV) sedation. Local anesthesia with 1% lidocaine is preferred because it does not interfere with the electrical activity of the heart (heartbeats).

General anesthesia or deep sedation may be preferred in some people in whom the expected procedural time is extensive, in whom the rhythm being investigated is hemodynamically unstable or who are unable to lie still. General anesthesia is also preferred for small children and younger adolescents.