Key result
Overdrive pacing remains an effective intervention for torsades de pointes, potentially working by narrowing the dispersion of ventricular refractoriness.
Why the study?
Does overdrive pacing prevent recurrence in patients with ventricular tachyarrhythmias, specifically torsades de pointes?
Does overdrive pacing prevent recurrence in patients with ventricular tachyarrhythmias, specifically torsades de pointes?
While largely abandoned for other ventricular tachyarrhythmias, overdrive pacing remains a useful intervention for temporarily preventing the recurrence of torsades de pointes.
Supports continued use for acute torsades de pointes; leaves open prospective validation of refractoriness dispersion effects.
Overdrive pacing was used for many years to prevent ventricular tachycardia and there are many reports of its effectiveness. Nevertheless, the use of overdrive pacing for most types of ventricular tachyarrhythmia has been abandoned. One notable exception is torsades de pointes, in which interventions that increase heart rate, including pacing, at least temporarily protect against recurrence. Overdrive may work by narrowing dispersion of ventricular refractoriness, and measurement of the latter could provide a marker to selectively apply overdrive pacing, thus increasing its usefulness.
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Peter R. Kowey (1983) conducted a review in Ventricular tachyarrhythmias. Overdrive pacing was evaluated. Overdrive pacing remains an effective intervention for torsades de pointes, potentially working by narrowing the dispersion of ventricular refractoriness.
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