Impiego combinato di pacemaker antitachicardico automatico e cardioverter-defibrillatore automatico impiantabile nella tachicardia ventricolare sostenuta ricorrente refrattaria ai farmaci.

Translated title of the contribution: Combination use of an automatic anti-tachycardia pacemaker and an automatic implantable cardioverter-defibrillator in sustained recurrent ventricular tachycardia resistant to drugs

G. Benedini, E. Caradonna, O. Alfieri, O. Visioli

Research output: Contribution to journalArticlepeer-review

Abstract

We used the combination of an antitachycardia automatic ventricular pacemaker with the automatic implantable cardioverter-defibrillator in two patients with sustained, recurrent, drug-resistant ventricular tachycardias in whom a surgical ablation was not indicated. The indications for the combined use of the two systems were the possibility to control: a) the ventricular tachycardias with ventricular programmed stimulation; b) the arrhythmias which might eventually degenerate into ventricular flutter or fibrillation (as a result of anti-tachycardia pacing) with the defibrillator. To avoid any possible interference between the two systems we used the following protocol: a) endocardial bipolar pacing; b) the sensing electrodes of the defibrillator were placed as far as possible from the endocardial one; c) a suitable programming of the pacemaker output; d) a careful selection of the anti-tachycardia pacing programme (burst rate inferior to the cut-off rate of the cardioverter-defibrillator and/or a duration of the burst pacing inferior to the arrhythmia sensing time of the defibrillator); e) use of cardioverter-defibrillators with a high cut-off rate. We never observed, during the follow-up (11 and 4 months, respectively), interference between the two systems. Both patients had ventricular tachycardia recurrences (51 and 3 episodes, respectively). The arrhythmias were correctly detected and interrupted by the pacemaker without the intervention of the defibrillator. These data confirm the feasibility of the combined use of the two systems in patients with ventricular tachycardias and, in selected cases, this approach is preferable. The anti-tachycardia pacemaker counteracts some limitations of the defibrillators available at present. It offers a protection against bradyarrhythmias and allows a more precise storage of arrhythmic events. The anti-tachycardia pacemaker often controls ventricular tachycardias without the intervention of the defibrillator, thus giving the same a longer life-span and allowing patients to avoid the shock.

Translated title of the contributionCombination use of an automatic anti-tachycardia pacemaker and an automatic implantable cardioverter-defibrillator in sustained recurrent ventricular tachycardia resistant to drugs
Original languageItalian
Pages (from-to)889-900
Number of pages12
JournalGiornale Italiano di Cardiologia
Volume19
Issue number10
Publication statusPublished - Oct 1989

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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