[Endocardial cardioversion--a new method for treating recurrent ventricular tachycardia].

Area of Science:

• Cardiology
• Electrophysiology

Context:

• Ventricular tachycardia (VT) poses a significant risk, often requiring invasive interventions.
• Current treatments for VT include anti-tachycardic pacing and external defibrillation.
• Investigating novel, less invasive methods for VT termination is crucial.

Purpose:

• To evaluate the efficacy and safety of endocardial cardioversion for terminating ventricular tachycardia.
• To determine the threshold energy required for successful endocardial cardioversion of VT.
• To assess the suitability of endocardial cardioversion for supraventricular tachyarrhythmias.

Summary:

• Endocardial cardioversion was tested in 17 patients with ventricular tachycardia, delivering microshocks via a right ventricular catheter.
• Successful reversion to sinus rhythm occurred in 26 of 33 VT episodes, with an average threshold of 0.77 J.
• The procedure was effective and safe for VT termination, even in patients refractory to pacing, but not suitable for supraventricular arrhythmias.

Impact:

• Endocardial cardioversion presents a safe and effective alternative for terminating ventricular tachycardia.
• This technique may be particularly beneficial for patients who do not respond to conventional therapies.
• Further research could refine endocardial cardioversion for broader applications in arrhythmia management.