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  • Title: Pacemaker-mediated tachycardias: a new modality of treatment.
    Author: Weber H, Schmitz L, Hellberg K.
    Journal: Pacing Clin Electrophysiol; 1984 Nov; 7(6 Pt 1):1010-6. PubMed ID: 6209620.
    Abstract:
    Three patients with pacemaker interactive drug resistant tachycardia underwent invasive electrophysiological studies. In the first patient, the retrograde conduction of the artificial reciprocating tachycardia was provided by two right-sided accessory pathways and the antegrade conduction by an atrial synchronous pulse generator. In addition, AV-nodal tachycardia occurred alternately. In the second patient with intermittent atrial flutter, the AV node and, coincidentally, an AV sequential pulse generator provided high-rate antegrade conduction to the ventricles. In the third patient with surgical complete heart block, intermittent AV-nodal tachycardia induced retrograde atrial activation while an atrial synchronous pacemaker provided the antegrade conduction. Electrode catheter exploration of the heart allowed localization and closed-chest ablation of the accessory pathways or AV node by delivering two to seven 200-joule direct-current shocks through the appropriate electrode of the exploring catheter. Thereby, pacemaker-mediated arrhythmias could be controlled in these patients in the follow-up of 6 to 8 months.
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