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Clinical Experience with Implantable Devices for Control of Tachyarrhythmias
Author(s) -
DULK KAREL den,
BERTHOLET MICHEL,
BRUGADA PEDRO,
BÄR FRITS W.,
DEMOULIN JEAN C.,
WALEFFE ANDRE,
BAKELS NOUD,
LINDEMANS FRED,
BOURGEOIS IVAN,
KULBERTUS HENRI E.,
WELLENS HEIN J.J.
Publication year - 1984
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1984.tb04949.x
Subject(s) - medicine , cardiology
Pacing is becoming an accepted form of treatment for reentry tachycardias. The different pacing modalities available and experience with a patient‐activated antitachycardia pacemaker are presented in this paper. This system has bidirectional communication between pacemaker and pacemaker‐activator and between pacemaker and prescription formulator (which is a sophisticated portable stimulator used for non‐invasive electrophysiological evaluation of the system). This pacemaker was implanted in 18 patients with drug‐resistant tachycardias. Six patients had ventricular tachycardia, 3 had A‐V nodal reentrant tachycardia, 4 had the concealed accessory pathway, and 5 had the WPW syndrome. In the 3 months before implantation the mean number of admissions for termination of tachycardia was 2.1 per patient‐month. During a follow‐up period of 3–26 months only 6 patients were admitted once for termination of tachycardia (0.02 admissions per patient‐month). The reasons for admission of these 6 patients were: defective pacemaker activator in 2 patients, inadequate control of tachycardia in 2 patients, inappropriate use of the device in 1, and inadequate intake of medication in 1. All these problems were solved easily. Eight pacemaker activators required reprogramming, which was done in 5 patients on an out‐patient basis. The interval scanning mode was used in 9 patients. Nine patients required more than 2 stimuli for reproducible termination. A step‐wise increase in number of stimuli was used in 5 patients. This system has proven to be a safe and effective form of treatment of drug‐resistant supraventricular and ventricular tachycardias and has resulted in marked improvement of the quality of life of these patients.