Termination of ventricular tachycardia by programmed extrastimuli from an externally-activated permanent pacemaker

Two patients with hemodynamically well-tolerated recurrent ventricular tachycardia, drug resistant and previously requiring numerous external electrical cardioversions, had a permanent pacemaker implanted which could be programmed to deliver extrastimuli to convert the ventricular tachycardia to normal sinus rhythm. The patient- or physician-activated device can be programmed to induce or terminate ventricular tachycardia with extrastimuli delivered at the predetermined intervals which consistently induced or terminated the arrhythmia in the electrophysiology laboratory, allowing repeated evaluation of drug regimens. The pacemaker has reliably, painlessly, and consistently induced and terminated repeated episodes of ventricular tachycardia. This programmable pacemaker offers an alternative therapy for patients with hemodynamically well-tolerated refractory ventricular tachycardia.