[Use of temporary pacemaker programming in VVT mode for the treatment of recurrent ventricular tachycardia]

This is a report of a 59-year-old man with a Björk aortic prosthetic valve and mitral commissurotomy with left ventricular dysfunction and recurrent ventricular tachycardia (VT) in spite of antiarrhythmic therapy with amiodarone. Serial electrophysiologic studies were performed using standard ventricular extrastimulation technique. During these studies, sustained VT was induced and terminated by programmable extrastimulus pacing. The usual rhythm of the patient was atrial fibrillation with slow ventricular rate. The Medtronic Spectrax model 5985 pulse generator was implanted. A temporary program converts this device from inhibited (VVI) to triggered (VVT) mode, permitting programmed ventricular stimulation through synchronization with chest wall stimulation by a standard external programmable stimulator. During episodes of VT the pacemaker was temporary programmed to the VVT mode with a refractory period of 220 msec. With the chest wall stimulation by a electrophysiology stimulator it was possible to convert the VT with 2 or 3 synchronised extra stimulus. Thanks to the triggered mode the pacemaker will fire when the chest wall is stimulated, working as an external electrophysiology stimulator.