Clinical use of an implantable automatic tachycardia-terminating pacemaker

A significant fraction of patients with supraventricular and ventricular tachycardia remains a therapeutic problem despite improvements in diagnostic testing, new drugs, and improved techniques for the evaluation of the efficacy of drug therapy. Pacing provides an alternative in selected patients. Pacing techniques may be used for arrhythmia suppression or termination and in rare instances may allow the substitution of a more easily managed arrhythmia. We have permanently implanted a new programmable, automatic tachycardia-terminating pacemaker in patients with drug-refractory supraventricular tachycardia. Following pacemaker implantation, successful tachycardia termination has been documented by ambulatory monitoring. Because of changing requirements for effective termination, we feel programmability is mandatory for successful long-term efficacy. We conclude that pacemaker therapy of supraventricular trachyarrthythmia with the automatic antitachycardia terminating pacemaker is safe, effective, and well tolerated.