Radiofrequency-Triggered Pacemakers: Uses and Limitations

Abstract

Patients (7) with either recurrent paroxysmal supraventricular tachycardia (5), alternating bradycardia-tachycardia (1), or ventricular tachycardia (1) underwent insertion of permanent radiofrequency-triggered pacemakers. Follow-up evaluation (36 .+-. 24 mo., mean .+-. SD) revealed that arrhythmias were well controlled in 5 of 7 patients, although 3 of the 5 required medication to decrease arrhythmia frequency. Overdrive pacing was ineffective in 1 patient with Wolff-Parkinson-White syndrome who had recurrent bouts of atrial fibrillation or atrial flutter. One additional patient with ventricular tachycardia became refractory to overdrive atrial pacing. These studies document the long-term effectiveness of radiofrequency pacemakers in some patients with recurrent refractory arrhythmias. Careful patient selection and electrophysiologic studies are mandatory before implantation of a permanent radiofrequency pacemaker. Physicians must be aware of the benefits and possible limitations of radiofrequency pacemakers to choose between pacemaker vs. surgical intervention in patients with cardiac arrhythmias refractory to standard drug therapy.