What question did this study set out to answer?

To evaluate and compare the efficacy of transvenous cardioversion and rapid ventricular pacing for terminating induced ventricular tachycardia in patients with organic heart disease.

July 1, 1985CirculationOpen Access

Comparative efficacy of transvenous cardioversion and pacing in patients with sustained ventricular tachycardia: a prospective, randomized, crossover study.

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Why the study?

Does transvenous cardioversion compared to rapid ventricular pacing improve the termination of induced ventricular tachycardia in patients with spontaneous ventricular tachycardia and organic heart disease?

Population

15 patients with spontaneous ventricular tachycardia and organic heart disease, mean age 60 +/- 10 years.

Comparison

Transvenous cardioversion vs Rapid ventricular pacing

Design

RCT, Randomized crossover sequence

Follow-up

Acute (during electrophysiologic studies)

Authors

SSSanjeev SaksenaElectrophysiology PCP Chandran YSYash ShahLifeForce Homoeopathy (India)

Discussion

Member takes

Implication

Rapid ventricular pacing may be preferred to minimize discomfort and arrhythmias; challenges routine transvenous cardioversion despite comparable efficacy in induced VT.

Key Points

To evaluate and compare the efficacy of transvenous cardioversion and rapid ventricular pacing for terminating induced ventricular tachycardia in patients with organic heart disease.
Prospective, randomized crossover study design
Induced ventricular tachycardia episodes in 15 patients with organic heart disease
Preselected electrical therapy protocol with transvenous cardioversion and rapid ventricular pacing in random sequence.
Transvenous cardioversion success rate was 83%, compared to 80% for rapid ventricular pacing (p > .1).
Transient supraventricular tachyarrhythmias occurred more frequently after transvenous cardioversion (23%) than after pacing (3%).
Significant patient discomfort was noted after transvenous cardioversion in 57% of cases.

Structured PICO

Population

15 patients with spontaneous ventricular tachycardia and organic heart disease (62 episodes of induced ventricular tachycardia), mean age 60 +/- 10 years.

Intervention

Transvenous cardioversion (incremental protocol of three sequential shocks: 0.5, 1.1, and 2.7 J)

Comparator

Rapid ventricular pacing (six asynchronous sequential bursts of 10 and 15 paced stimuli at 90%, 75%, and 65% of ventricular tachycardia cycle length)

Outcome

Termination of induced ventricular tachycardiasurrogate

Transvenous cardioversion and rapid ventricular pacing have comparable efficacy for terminating induced ventricular tachycardia, but cardioversion is associated with more frequent transient supraventricular tachyarrhythmias and patient discomfort.

Cite This Study

Saksena et al. (1985) studied this question.

synapsesocial.com/papers/6a7406edf2548bdd13cdefbd https://doi.org/10.1161/01.cir.72.1.153

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Implication

Rapid ventricular pacing may be preferred to minimize discomfort and arrhythmias; challenges routine transvenous cardioversion despite comparable efficacy in induced VT.

Comparative efficacy of transvenous cardioversion and pacing in patients with sustained ventricular tachycardia: a prospective, randomized, crossover study.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Comparative efficacy of transvenous cardioversion and pacing in patients with sustained ventricular tachycardia: a prospective, randomized, crossover study.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider