Advances in cardiac electrophysiology have clarified some of the mechanisms of tachydysrhythmias and have characterized tachycardias that are amenable to pace termination. Tachydysrhythmias most likely to be terminated by pacing techniques tend to be slow, re-entrant tachycardias. Although single extrastimulation can be effective, its yield is relatively low. Delivery of multiple extrastimuli or burst pacing are more effective than single extrastimulation at the expense of a higher risk of tachycardia acceleration or transformation of the rhythm to fibrillation. The use of pacing for the termination of tachydysrhythmias has primarily been limited to the acute care setting, although permanently implantable antitachycardia pacemakers are being used in increasing numbers. While these devices have been approved by the Food and Drug Administration (FDA) for the treatment of supraventricular tachydysrhythmias, their use to treat ventricular tachydysrhythmias has produced mixed results and remains investigational. In some cases of sustained ventricular tachycardia, automatic cardioverter/defibrillators have been implanted along with antitachycardia pacemakers to provide high-energy shock back-up in case of tachycardia acceleration by the pacemaker. Soon, devices will be available which will combine, in a single unit, antitachycardia pacing and high-energy cardioversion/defibrillation
Cardiac Pacemakers| February 01 1991
Pacing for Tachydysrhythmias
Priscilla Roman-Smith, RN, BSN
From the Division of Cardiology, St. Louis University Hospital, St. Louis, Missouri.
Reprint requests to Priscilla Roman-Smith, RN, BSN, Cardiology Division, 12th Floor, St. Louis University Hospital, 3635 Vista at Grand, PO Box, 15250, St. Louis, MO 63110-0250.
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AACN Adv Crit Care (1991) 2 (1): 132–139.
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Priscilla Roman-Smith; Pacing for Tachydysrhythmias. AACN Adv Crit Care 1 February 1991; 2 (1): 132–139. doi: https://doi.org/10.4037/15597768-1991-1021
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