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Clinical Experience with a New Software‐Based Antitachycardia Pacemaker for Recurrent Supraventricular and Ventricular Tachycardias
Author(s) -
FROMER MARTIN,
GLOOR HANS,
KUS TERESA,
SHENASA MOHAMMAD
Publication year - 1990
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.1540-8159.1990.tb02126.x
Subject(s) - medicine , tachycardia , cardiology , supraventricular tachycardia , atrial flutter , orthodromic , atrial tachycardia , electrophysiology study , ventricular tachycardia , atrial fibrillation , anesthesia , electrocardiography , catheter ablation , electrophysiology
The Intermedics Intertach 262–12 tachycardia reversion pulse generator was implanted in 14 patients (six male, eight female, mean age at implantation 45 ± 16 years) with recurrent symptomatic tachycardias. Six patients had atrioventricular (AV) nodal reentrant tachycardia, three patients had orthodromic tachycardia with Wolff‐Parkinson‐White syndrome, two had circus movement tachycardia via a concealed bypass tract, two had ventricular tachycardia, one patient had atrial flutter. Mean duration of symptoms before implantation was 8 ± 4 years and mean number of antiarrhythmic drug trials was 3.5 ± 1. The primary tachycardia response mode consisted of autodecremental pacing in one patient, burst pacing in two patients, and adaptive scanning of the initial delay or burst cycle length in eleven patients. The secondary tachycardia response mode consisted of autodecremental pacing in four patients, burst pacing in three patients and burst scanning in four patients. Tachycardia response was automatic in all but one patient with ventricular tachycardia. During a follow‐up period of 30.5 ± 10.6 months, one patient with ventricular tachycardia died from a nonarrhythmic cause, Reinterventions were necessary due to electrode fracture in one patient and due to pacemaker software defect in another one. Two patients underwent surgical cure of their arrhythmia: one patient with atrial flutter and one patient with AV nodal reentry tachycardia, 24 months and 11 months postpacemaker implantation, respectively. Four patients required digitalis to prevent pacing induced atrial fibrillation. Other proarrhythmic effects were not encountered. The pacemaker proved to be a versatile system with reliable tachycardia detection and termination functions. It provided a valuable adjunctive therapy in these selected patients.