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Is there a universal antitachycardia pacing mode?

K den Dulk, I E Kersschot, P Brugada

    The American Journal of Cardiology
    |April 15, 1986
    PubMed
    Summary
    This summary is machine-generated.

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    A novel pacing mode with adaptive intervals effectively terminated most tachycardias, offering a potential universal solution for antitachycardia pacing and reducing patient testing time.

    Area of Science:

    • Cardiology
    • Biomedical Engineering
    • Electrophysiology

    Background:

    • Antitachycardia pacing aims to terminate abnormal heart rhythms.
    • Current pacing modes require extensive individual testing and tailoring.
    • A universal pacing mode could streamline treatment and save time.

    Purpose of the Study:

    • To evaluate a novel pacing mode with automatically increasing stimuli and adaptive coupling intervals as a potential universal antitachycardia pacing mode.
    • To compare the efficacy of this test mode against established methods in patients with pacemakers and during electrophysiologic studies.

    Main Methods:

    • Prospective evaluation of the test pacing mode in three patient groups.
    • Comparison with previously tailored modes in patients with implanted antitachycardia pacemakers.

    Related Experiment Videos

  • Comparison with scanning and asynchronous burst modes during invasive electrophysiologic studies.
  • Testing in various conditions including supine, upright, and post-exercise positions.

    • Main Results:

    • The test mode successfully terminated 207 out of 209 tachycardias (156 supraventricular tachycardias [SVT] and 53 ventricular tachycardias [VT]) without prior knowledge of optimal settings.
    • One episode of VT was not terminated, and two episodes in recent myocardial infarction patients required defibrillation due to acceleration or ventricular fibrillation (VF).
    • The scanning mode failed in 2 SVT cases and accelerated VT in one patient with recent myocardial infarction.

    Conclusions:

    • The adaptive pacing mode shows promise as a universal antitachycardia pacing solution, effectively terminating a high percentage of tachycardias.
    • This mode has the potential to significantly reduce the time and effort associated with tailoring pacing therapies.
    • Further investigation is warranted, particularly for patients with recent myocardial infarction, to optimize safety and efficacy.