Open AccessThe effect of chronic atrial overdrive suppression pacing on the incidence of supraventricular tachyarrhythmias
Author(s) -
Shandling Adrian H.,
Crump Randy,
Nolasco Maria,
Lorenz Linda M.,
Li Curtis K.
Publication year - 1992
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960151212
Subject(s) - medicine , cardiology , supraventricular tachycardia , tachycardia , bradycardia , supraventricular arrhythmia , atrial flutter , heart rate , anesthesia , atrial tachycardia , crossover study , reentry , atrial fibrillation , catheter ablation , blood pressure , alternative medicine , pathology , placebo
Chronic overdrive suppression pacing has been suggested as an effective adjunctive method for reducing the incidence of cardiac tachyarrhythmias. Documentation of effectiveness during prolonged monitoring is lacking, however. To assess more accurately the long‐term utility of this treatment modality for medically refractory supraventricular tachyarrhythmias (SVTs), 10 patients with atrially implanted Intermedics Intertach pacemakers were randomly assigned to either a low or a high bradycardia (back‐up) pacing rate. SVT counts were performed during matching follow‐up periods both at the initial rate and after rate crossover. The primary antitachycardia modality of this pacemaker (P mod) provides burst pacing to terminate tachycardia episodes, and P mod counters were utilized to quantitate SVT episodes. Tachycardia termination algorithms were programmed to “no restart” and were not changed during the study. The P mod use counter, therefore, reflected the number of discrete episodes of SVTs. Pacemaker implantation diagnoses include atrial flutter, concealed bypass tract, AV nodal reentry, intraatrial reentry, and Wolff‐Parkinson‐White associated tachycardia. Patient age was 59 ± 18yrs. The average pacemaker backup low rate was 45.7±4 versus a back‐up high rate of 85.1 ±2 beats/min. Follow‐up was for 57.4 days±33 days at the low rate and 57.3 days ±34 days at the high rate (r=0.99). There was no difference in SVT incidence with a P mod usage of 98.4± 106 at the low rate and 100.8±94 at the high rate (p=NS). In this blinded, randomized crossover trial, chronic atrial overdrive suppression pacing did not reduce the overall incidence of SVT episodes during prolonged monitoring.