Summary: 9 patient with drug-resistant supraventricular tachycardia was well controlled for 8 years with a patient-activated rapid atrial pacemaker until she developed symptomatic bradycardic episodes. A multiprogrammable vcntricular pacemaker was implanted. Asswsment Qf the interactions between the two pacemakers demonstrated inhibition of VVI pacing by the atrial stipulator initially. Two months after implant no interaction was seen. At no time was VVT pacing affected by the atrial stimulator. Thus, interactions between these two units' can occur and a multiprogrammable pacemaker should be used in this situation as it offers the flexibility to minirpize any interaction that might be present.Wey war+: multiprograrnmable ventricular pacemaker, rapid atrial stimulator, patient-activated atrial pacemaker, interactions lntroductionThe common approach to the treatment of bradycardia-tachycardia syndrome is to implant a pacemaker to control the bradycardia aspect and rely on drugs to control the tachycardia aspect. However, if the patient proves to have drug-resistant supraventricular tachycardia the situation is much more difficult. Further complexity is added when the bradycardia and tachycardia aspects present at different times. This report concerns a patient who had been using a patient-activated radio-frequency atrial stimulator for the control of drug-resistant supraventricular tachycardias for 8 years prior to the development of symptomatic bradycardia for which she required insertion of a ventricular pacemaker. The interactions between these two electronic units were assessed on several occasions. Case PresentationA female patient with known rheumatic heart disease had mitral and aortic valve replacement surgery at age 41. Postoperatively, she suffered from recurrent atrial tachycardia which was resistant to medical therapy and a patient-activated, radio-frequency rapid atrial stimulator (RAS, Model 5998, Medtronic, Inc., Minneapolis, Minnesota) was implanted. This effectively controlled her symptoms for 8 years, she then developed syncopal episodes. Although she complained of some lightheadedness following RAS termination of tachycardia, her true syncopal episodes occurred unrelated to the use of this device. Ambulatory monitoring demonstrated both periods of marked sinus bradycardia in the absence of tachycardia and marked overdrive suppression following short bursts of atrial tachycardia of which the patient was apparently unaware (Fig. 1). A multiprogrammable (MP) ventricular pacemaker (Cyberlith, Intermedics, Inc., Freeport, Texas) was implanted (Fig. 2).
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.