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‘Long‐Term Results of Antitachycardia Pacing in Patients with Supraventricular Tachycardia
Author(s) -
SCHNITTGER INGELA,
LEE JOHN T.,
HARGIS JANE,
WYNDHAM CHRISTOPHER R.G.,
ECHT DEBRA S.,
SWERDLOW. CHARLES D.,
GRIFFIN JERRY C.
Publication year - 1989
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.1540-8159.1989.tb05031.x
Subject(s) - medicine , supraventricular tachycardia , cardiology , tachycardia , atrial fibrillation , reentry , sinus rhythm , cardioversion , atrial tachycardia , supraventricular arrhythmia , anesthesia , catheter ablation
Between 1979 and 1984 the Cybertach‐60, (Intermedics, Inc. Model 262–01), a programmable, automatic antitachycardia pacemaker was implanted in 11 patients who had drug‐refractory supraventricular tachycardia (SVT). The patients have been followed for a total of 64–108 (mean 84 months). All patients were symptomatic and had failed two or more drugs and six patients had required prior DC cardioversion. The mechanism of supraventricular tachycardia was atrioventricular (AV) nodal reentry in six patients, AV reentry in four patients, and atrial tachycardia in one patient. Preoperatively all patients had reliable termination of the tachycardia without induction of atrial fibrillation by pacing methods available to Cybertach‐60. Postimplant, Cybertach‐60 reliably terminated all episodes of tachycardia without ancillary drug therapy. Nevertheless, at long‐term follow‐up antitachycardia pacing was effective and safe in the minority (36%). with only four patients out of eleven still using a pacemaker for supraventricular tachycardia. One of these four patients required additional drug therapy. In one of the patients, the Cybertach‐60 was replaced after 78 months by a more advanced device, (Intertach, Intermedics, Inc.) because of a depleted Cybertach‐60 battery. In seven patients who no longer use antitachycardia pacing for termination of tachycardia, one patient developed atrial fibrillation during tachycardia termination (at 58 months postimplant). Three patients experienced induction of tachycardia or atrial fibrillation by the pacemaker due to undersensing of sinus P waves (at 36, 48, and 51 months). One patient had inappropriate rate detection while in sinus rhythm triggering the tachycardia termination burst from the pacemaker and subsequent SVT induction. Although pace termination of supraventricular tachycardia was effective in two patients, they chose elective ablation (AV nodal and accessory pathway, respectively, at 74 and 6 months) due to frequent symptomatic SVT.