Related Experiment Videos
Pacemaker and defibrillator combination therapy for recurrent ventricular tachycardia.
M Masterson1, S L Pinski, B Wilkoff
1Department of Cardiology, Cleveland Clinic Foundation, One Clinic Center, Ohio 44195.
Cleveland Clinic Journal of Medicine
|June 1, 1990
Summary
Combining antitachycardia pacemakers and automatic implantable cardioverter defibrillators can effectively manage ventricular tachycardia in selected patients. Careful programming ensures synergistic device function, reducing arrhythmias while allowing for reduced antiarrhythmic drug use.
Area of Science:
- Cardiology
- Biomedical Engineering
- Electrophysiology
Background:
- Drug-refractory sustained ventricular tachycardia poses significant risks.
- Automatic implantable cardioverter defibrillators (AICDs) are crucial for managing life-threatening arrhythmias.
- Antitachycardia pacemakers (ATPs) offer an alternative pacing-based therapy for tachycardia termination.
Purpose of the Study:
- To evaluate the synergistic efficacy of combined ATP and AICD implantation in patients with drug-refractory, pace-terminable ventricular tachycardia.
- To assess the safety and management of ventricular tachycardia episodes using this dual-device strategy.
- To determine the impact on concomitant antiarrhythmic drug requirements.
Main Methods:
- Implantation of both ATP and AICD systems in 10 highly selected patients.
- Monitoring of device performance and management of ventricular tachycardia episodes over an 8 +/- 4.8-month period.
- Detailed device programming and testing to ensure system compatibility and efficacy.
Main Results:
- ATP devices detected 1,542 ventricular tachycardia episodes, appropriately managing 1,373.
- AICDs activated in all patients; two instances of AICD discharge occurred due to ATP-induced tachycardia acceleration.
- Concomitant antiarrhythmic drug dosages were reduced but not fully discontinued.
Conclusions:
- The combination of ATP and AICD systems can synergistically manage malignant ventricular arrhythmias in carefully selected patients.
- Meticulous device programming and testing are essential for optimal performance of combined systems.
- Dual-device therapy offers a valuable strategy for reducing ventricular tachycardia burden and potentially decreasing antiarrhythmic drug dependence.