Premium
Patient Initiated Implantable Pacemakers for Paroxysmal Supraventricular Tachycardia
Author(s) -
Vohra J.,
Hamer A.,
Mond H.,
Sloman G.,
Hunt D.
Publication year - 1981
Publication title -
australian and new zealand journal of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0004-8291
DOI - 10.1111/j.1445-5994.1981.tb03732.x
Subject(s) - medicine , paroxysmal supraventricular tachycardia , supraventricular tachycardia , cardiology , tachycardia , cardiac pacing , electrocardiography
Patient initiated implantable pace makers for paroxysmal supraventricular tachycardia. J. Vohra, A. Hamer, H. Mond, G. Sloman and D. Hunt, Aust. N.Z. J. Med ., 1981, 11, pp. 27–34. Seven patients with recurrent paroxysmal supraventricular tachycardia (PSVT) resistant to standard drug therapy were treated with patient initiated implantable pacemakers. All patients had required frequent hospital admissions and cardio versions prior to pace maker implantation Two patients had Wolff‐Parkinson‐White (WPW) syndrome on their surface ECGs and five patients had no ECG evidence of pre excitation. All patients had detailed electrophysiological studies. Three patients had junctional tachycardia, one patient had reciprocating atrial tachycardia and in three, including one with normal surface ECG, retrogradely conducting accessory atrio‐ventricular connections (AAVC) formed a part of the tachycardia circuit. Initiation and termination of tachycardia were re‐checked at subsequent studies On the basis of these studies, two patients with WPW syndrome had right ventricular endocardial leads and custombuilt, magnet actuated pacemakers capable of delivering right ventricular coupled stimuli at fixed, present intervals of 200 and 400 ins. Both these pacemakers provided inconsistent reversions and proved unsatisfactory In the remaining five patients, a unipolar tined J‐shaped right atrial (RA) lead (Medtronic ‡‡ 6991) and a radiofrequency (RF) receiver (Medtronic 5998T) were implanted and enabled patients to overdrive PSVT. The follow‐up period in these patients ranged from 14 to 20 months. Several episodes of PSVT have been consistently reverted and none have required hospitalisation or cardio‐version. Two patients had transient atrial fibrillation following the application of RF pacemaker. Three have required no antiarrhythmic drugs and in two the drug therapy has been greatly reduced and simplified. The Medtronic 6991 lead provided satisfactory RA stimulation without dislodgement. In carefully selected patients with PSVT, RF pacemakers provide a useful Mode of treatment