Why the study?
Do auto increment, auto burst, and random burst pacing modalities safely and effectively terminate ventricular tachyarrhythmias in patients in the electrophysiology laboratory?
Do auto increment, auto burst, and random burst pacing modalities safely and effectively terminate ventricular tachyarrhythmias in patients in the electrophysiology laboratory?
Antitachycardia pacing is effective for ventricular tachyarrhythmias with cycle lengths >230 ms but carries a 15% risk of acceleration, necessitating defibrillating back-up.
ATP effective for VT cycle lengths >230 ms; confirms burst-pacing utility in RCT but requires defibrillation backup.
This study was undertaken to determine the safety and efficacy of three different pacing modalities on the termination of ventricular tachyarrhythmias. Thirty-two patients were studied in the electrophysiology laboratory. Three randomized pacing modalities were selected for attempted conversion: auto increment, auto burst, and random burst. In all three groups, arrhythmias with cycle lengths shorter than 230 ms required DC shock, with one exception. Those longer than 230 ms were terminated by pacing in 85% of cases. There was a 15% rate of acceleration. Thus, antitachycardia pacing for ventricular tachyarrhythmias should be considered only with defibrillating back-up.
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Holley et al. (1986) studied this question.
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