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European Heart Journal 1980 1(3):165-170;
Copyright © 1980 by the European Society of Cardiology.
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© 1980 The European Society of Cardiology

Use of a multi-programmable pacemaker in the dual demand mode: influence of pacing rate on termination of tachycardias

E. SOWTON, D. B. O'KEEFFE and P. V. L. CURRY

Guy's Hospital, Department of Cardiology London SE1 9RT, U.K.

Received 26 February 1980; .

Requests for reprints to: Edgar Sowton, M.D., F.R.C.P., Consultant Cardiologist, Guy's Hospital, London SE1 9RT, U.K.

A multi-programmable pacemaker (Siemens-Elema Model 668) has been used in the dual demand mode to treat four patients with re-entry tachycardias. In each case excellent clinical control of frequent episodes of tachycardia was obtained over the follow-up time of 12 months. The influence of different pacing rates was investigated. It was found that the time taken to terminate an episode of tachycardia was not consistently related to the pacing rate because of the variable timing of the first pacemaker impulse during the tachycardia cycle. It was concluded that pacing rates should be chosen so that they are fast enough to prevent recurrence of a tachycardia following termination of an episode, and should not be a simple fraction of the tachycardia rate. The possibility of programming hysteresis allows rapid post-tachycardia rates to be obtained temporarily.

Dual demand pacing at present offers a completely automatic method of electrical termination of re-entry tachycardias, but is still restricted to patients whose episodes can be interrupted by a single ectopic beat.

Key Words: Multi-programmable • re-entry tachycardia


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