Permanent pacemakers, particularly those with cardioversion/defibrillation capabilities, serve as a valuable adjunctive fail-safe therapy for patients with reentrant tachycardias on antiarrhythmic drugs.
May support adjunctive pacing for drug testing and breakthrough in reentrant tachycardias; hypothesis-generating and requires prospective validation.
Improved pacemaker technology has permitted application in more diverse groups of patients. A more recently described subset appears to be those with reentrant tachycardias treatable with antiarrhythmic drugs. Here, pacing offers the ability both to test the efficacy of a drug regimen and to provide adjunctive "fail-safe" therapy for those with episodic breakthrough. With the advent of more sophisticated devices, especially those with cardioversion/defibrillation capability, we anticipate a growing interest in these applications which will undoubtedly benefit patients.
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Friehling et al. (1988) studied this question.
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