Antitachycardia pacing, alone or with an AICD, provided successful pace termination of spontaneous ventricular tachycardia in 7 of 9 (78%) patients programmed for automatic pacing.
Observational (n=11)
Does antitachycardia pacing alone or with AICD safely and effectively terminate ventricular tachycardia in patients with medically refractory ventricular tachycardia?
Antitachycardia pacing, particularly when combined with an AICD for safety, is an effective treatment for medically refractory ventricular tachycardia, though careful programming is required to avoid adverse device-device interactions.
This article describes our experience with an antitachycardia pacemaker alone (N = 3) or in combination with an automatic implantable cardioverter defibrillator (AICD, N = 8) in the treatment of ventricular tachycardia. Eleven patients (mean ejection fraction 31%, mean age 67 years) received an antitachycardia pacemaker. Nine had their units programmed for automatic antitachycardia pacing, one unit was programmed to automatic antitachycardia pacing by magnet activation only, and one to tachycardia detection and bradycardia support. Of the nine patients with automatic antitachycardia pacing, seven received appropriate and successful pace termination of spontaneous ventricular tachycardia at up to 120 times per month. Eight of these nine have had AICD implantations as well. There were no operative complications. Over a mean (+/- SD) follow-up of 12.1 +/- 9.3 months (range 3-29 months), there have been two deaths, both due to heart failure. There have been four AICD discharges in three patients. Two units discharged in a clinically appropriate setting. The other two units, both with rate cutoffs less than 200 beats/min, were inadvertently triggered by the antitachycardia pacemaker and/or the underlying rate. In addition to the careful selection of the defibrillator rate cutoff, adverse device-device interactions were avoided by careful intraoperative lead positioning, and the disabling of bradycardia pacing when not needed or contraindicated. Antitachycardia pacing, with the safety provided by the AICD, is an effective treatment for patients with medically refractory ventricular tachycardia.
Newman et al. (Tue,) conducted a observational in Ventricular tachycardia (n=11). Antitachycardia pacemaker alone or with an automatic implantable cardioverter defibrillator (AICD) was evaluated on Appropriate and successful pace termination of spontaneous ventricular tachycardia. Antitachycardia pacing, alone or with an AICD, provided successful pace termination of spontaneous ventricular tachycardia in 7 of 9 (78%) patients programmed for automatic pacing.