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Related Experiment Videos

Initial clinical experience with the pacemaker-cardioverter-defibrillator.

R Yee1, G J Klein, G M Guiraudon

  • 1Department of Medicine, University Hospital, London, Ontario.

The Canadian Journal of Cardiology
|May 1, 1990
PubMed
Summary

A new pacemaker-cardioverter-defibrillator effectively treated ventricular tachycardia and fibrillation in four patients. The device provided automatic, graded therapies, showing promise for managing these life-threatening arrhythmias.

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Area of Science:

  • Cardiology
  • Medical Devices
  • Electrophysiology

Background:

  • Drug-refractory ventricular tachycardia and fibrillation pose significant risks.
  • Current treatment options may be limited for some patients.

Purpose of the Study:

  • To evaluate the safety and efficacy of a new multiprogrammable pacemaker-cardioverter-defibrillator (PCD) in patients with drug-refractory ventricular arrhythmias.
  • To assess the device's ability to deliver graded therapies for ventricular tachycardia and fibrillation.

Main Methods:

  • Implantation of a Medtronic PCD 7215 in four patients using epicardial patch electrodes and a ventricular lead.
  • The device was programmed with separate detection criteria for ventricular tachycardia and fibrillation.
  • Automatic delivery of up to four therapies per episode, including antitachycardia pacing, cardioversion, defibrillation, and bradycardia pacing.

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Main Results:

  • Over a 1.5 to 23-month follow-up, the device detected and treated 161 ventricular tachycardia (VT) and 9 ventricular fibrillation (VF) episodes.
  • Antitachycardia pacing successfully terminated 88.5% of VT episodes; 7.2% required low-energy cardioversion.
  • All 9 VF episodes were successfully defibrillated; no device malfunctions or inappropriate therapies were observed.

Conclusions:

  • The multiprogrammable pacemaker-cardioverter-defibrillator demonstrates potential usefulness in managing drug-refractory ventricular tachycardia and fibrillation.
  • The device provides reliable, graded therapeutic options, including defibrillation and bradycardia pacing capabilities.
  • Early results suggest this programmable device is a promising option for patients with life-threatening ventricular arrhythmias.