Elsevier

American Heart Journal

Volume 79, Issue 1, January 1970, Pages 44-50
American Heart Journal

Clinical communication
Suppression of refractory recurrent ventricular tachycardia by transvenous rapid cardiac pacing and antiarrhythmic drugs: Report of seven cases

https://doi.org/10.1016/0002-8703(70)90392-3Get rights and content

Abstract

Rapid cardiac pacing, alone or in combination with antiarrhythmic drugs, was employed in 7 patients with recurrent ventricular tachycardia or fibrillation, but without heart block or sinus bradycardia between attacks of tachyarrhythmia. In all of the 7 patients there was serious underlying cardiac disease and in 4 drug toxicity was an important causative factor. Previous reports, usually of solitary cases, suggested that the tachyarrhythmia was consistently suppressed when the pacing rate exceeded 110 per minute, whereas lower rates were often ineffective. In our experience pacing was effective in 4 of the 7 patients and was ineffective in 2 patients with maximal pacing of 120 per minute and in one who was paced at 150 per minute. One of the latter three recovered spontaneously after ineffective pacing was discontinued. Temporary control was obtained in some cases by inducing sinus tachycardia with intravenous atropine and isoproterenol until a pacemaker could be inserted. The antiarrhythmic effect of rapid pacing may be due to shortening of diastole and abbreviation of repolarization, thus inhibiting asynchronous areas of repolarization with local potential differences. In this series of patients there is one in whom previously refractory ventricular tachycardia has been suppressed for 14 months by means of rapid pacing with a permanently implanted pacemaker and a combination of propranolol and digoxin.

References (21)

There are more references available in the full text version of this article.

Cited by (0)

Supported by United States Public Health Service Grants HE 09416-03 and HE 5240-09.

View full text