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Pacemaker‐mediated Tachycardias: A New Modality of Treatment
Author(s) -
WEBER HELMUT,
SCHMITZ LOTHAR,
HELLBERG KLAUS
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.tb05653.x
Subject(s) - medicine , cardiology , atrial flutter , tachycardia , catheter ablation , ablation , accessory pathway , heart block , anesthesia , electrocardiography
Three Patients with pacemaker interactive drug resistant tachycardia underwent invasive electrophysiological studies. In the first patient, the retrograde conduction of the artificial reciprocating tachycardia was provided by two right‐sided accessory pathways and the antegrade conduction by an atrial synchronous plus generator. In addition, AV nodal tachycardia occurred alternately. In the second patient with intermittent atrial flutter, the AV node and, coincidentally, an AV sequential pulse generator provided high‐rate antegrade conduction to the ventricles. In the third patient with surgical complete heart block, intermittent AV‐nodal tachycardia induced retrograde atrial activation while an atrial synchronous pacemaker provided the antegrade conduction. Electrode catheter exploration of the heart allowed localization and closed‐chest ablation of the accessory pathways or AV node by delivering two to seven 200‐Joule direct‐current shocks through the appropriate electrode of the exploring catheter, Thereby, pacemaker‐mediated arrhythmias could be controlled in these patients in the follow‐up of 6 to 8 months.