Clinical Experience with the Siemens Pacesetter Siecure

Siemens Pacesetter Siecure. The Siemens Pacesetter P59 “Siecure” is a third‐generation implantable cardioverter defibrillator offering tiered therapy for termination of tachyarrhythmias. The device is highly programmable and is software loaded allowing telemetry upgrade. It has unique algorithms allowing‘'step up or down” of response according to the nature of the tachycardia. Extensive memory, analysis, and Holter monitoring functions afford excellent opportunities to monitor tachycardias and device response postimplantation. This article reports on the first six patients in whom the device was implanted (five male, one female, 33 to 65 years, mean 49). All had electrophysiologic study‐proven, hemodynamically unstable, drug refractory ventricular arrhythmias. The devices were implanted transthoraci‐cally with no peri‐ or postoperative complications. All patients had malignant arrhythmias induced perioperatively and noninvasively 6 weeks postoperatively, confirming appropriate device response and excellent tachycardia sensing functions. One patient has required reintroduction of amiodarone due to increasing frequency of ventricular tachycardia hut the remainder remain free of antiarrhythmic drug therapy up to 1 year postimplantation. The antitachycardia pacing function was used successfully six times to terminate arrhythmias in these patients, avoiding the need for cardioversion or defibrillation, which are more unpleasant and energy consuming modalities of treatment. ( J Cardiovasc Electrophysiol, Vol. 3, pp. 515–522, October 1992 )