Combined use of an antitachycardia pacemaker and AICD reliably terminated ventricular tachyarrhythmias 20 to 327 times per patient, with the AICD successfully treating pacing-induced acceleration.
Observational (n=6)
UNLABELLED: Antitachycardia pacing in ventricular tachyarrhythmias (VT) is associated with potential acceleration of VT; frequency of VT and discomfort of the patient (pt) can limit treatment with the AICD. We therefore evaluated the combined use of antitachycardia pacing and AICD in 6 of 14 patients (age 50-70, mean 60 years) with AICD implantation because of VT, which could be terminated by temporary overdrive pacing. With the interactive mode of the Tachylog, termination of VT by the pacemaker as well as by the AICD was assessed after implantation. In the automatic mode, the Tachylog functioned as a bipolar VVI device with antitachycardia burst stimulation: 2-5 stimuli, interval 260-300 ms, 1-2 interventions. During follow-up of 12 +/- 5 months, the Tachylog terminated VT reliably 20 to 327 times per patient. In three patients, burst stimulation accelerated VT, which was terminated then by the AICD discharge. CONCLUSION: Drug resistant ventricular tachyarrhythmias can be terminated by the Tachylog pacemaker avoiding patients' discomfort. In case of acceleration, ventricular tachyarrhythmias can be controlled by the automatic implantable cardioverter/defibrillator. A universal pacemaker should combine antitachycardia pacing with back-up defibrillation mode.
Lüderitz et al. (Sat,) conducted a observational in Ventricular tachyarrhythmias (n=6). Combined use of antitachycardia pacing (Tachylog) and AICD was evaluated on Termination of VT by the pacemaker as well as by the AICD. Combined use of an antitachycardia pacemaker and AICD reliably terminated ventricular tachyarrhythmias 20 to 327 times per patient, with the AICD successfully treating pacing-induced acceleration.