[Treatment of refractory tachycardias using an implantable cardiac stimulator]

Treatment of tachycardia by permanent cardiac stimulation involves the application of techniques developed in laboratories of clinical cardiac electrophysiology. Clinicians using such treatment must possess detailed knowledge of the physiopathology of arrhythmias and of pacemaker technology, which is essential in the correct selection of patients. We report therapeutic (and not prophylactic) stimulation techniques for treatment of tachycardia, and discuss the possibilities of existing pacemakers and their clinical performance in the light of our own experience and literature data. The results are very promising and suggest that this is a treatment of the future for certain refractory supraventricular tachycardias, and particularly for rapid ventricular tachyarrhythmias. The efficacy and long-term value of this costly treatment in such cases must be evaluated by further studies.