The Treatment of Ventricular Tachyarrhythmias

To the Editor: Mason and his colleagues are to be commended for undertaking the first large, randomized study to compare the roles of electrophysiologic testing and ambulatory monitoring in predicting the efficacy of antiarrhythmic drugs (Aug. 12 issue)¹–³. However, Dr. Mason's conclusion about the effect of the study findings on the approach to patients with serious ventricular arrhythmias is misleading. The first article reporting on the Electrophysiologic Study versus Electrocardiographic Monitoring (ESVEM) trial¹ offers a direct comparison of electrophysiologic testing with Holter-guided therapy; its conclusion simply states, “There was no significant difference [between the two methods].” However, the…