Arrhythmia control by cardiac stimulation.

Abstract

Cardiac programmed stimulation in the control of tachyarrhythmias offers encouraging prospectives. We describe two devices which utilize radiofrequency as a means of synchronization and stimulation and can be triggered by the patient himself when tachycardia occurs. In addition we introduce a third anti-tachycardia device, completely automatic, which can be used in cardiologic departments. The first device described permits critical stimulation and can be programmed to deliver a single or double synchronized impulse. The second device, which utilizes the same implanted unit and electrode as used for critical stimulation, when activated searches the tachycardia interruption zone by scanning. The third device, based on the same principles, has a rate discriminator that activates the scanning stimulation. We treated 12 patients: 8 suffering from paroxysmal supraventricular tachycardia (4 with Wolff--Parkinson--White syndrome, 2 with intranodal reentry, 2 with brady--tachy syndrome); 2 patients with ventricular recurrent tachycardia; 1 with atrial flutter; and another with iterative junctional tachycardia. The follow-up varied for every patient from 6 yr to 3 mth.