Pacemaker‐mediated Tachycardias: A New Modality of Treatment
- 1 November 1984
- journal article
- case report
- Published by Wiley in Pacing and Clinical Electrophysiology
- Vol. 7 (6), 1010-1016
- https://doi.org/10.1111/j.1540-8159.1984.tb05653.x
Abstract
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 pulse 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.Keywords
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