Demand Pacemaker for Refractory Paroxysmal Supraventricular Tachycardia

PAROXYSMAL supraventricular tachycardia may resist conventional drug therapy and seriously incapacitate the patient. Electrophysiologic studies may help to define refractory cases in which alternative nonpharmacologic measures may be of value. In the patient described below, competitive ventricular pacing was used to terminate episodes of refractory supraventricular tachycardia not associated with the pre-excitation syndrome. The mechanism ol action was demonstrated to be retrograde depolarization of the atrioventricular nodal tissues responsible for maintenance of the tachycardia.Case ReportA 28-year-old woman was admitted to the Hospital of the University of Pennsylvania in 1964 because of recurrent episodes of rapid heart action associated . . .