Anti-Tachycardia Pacing and Cardioversion

  • Michael L. Hardage
  • Michael B. Sweeney
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 188)


ALTHOUGH the primary focus of this text is on defibrillation issues, it is important to provide a discussion of therapies for ventricular tachycardias (VTs, that is, non-fibrillation tachyarrhythmias). In fact, tachycardia therapy is delivered much more frequently than ventricular fibrillation (VF) therapy in the general population of patients presenting with ventricular tachyarrhythmias in whom have implanted tiered therapy devices have been implanted. Patients who experience only primary ventricular fibrillation, exclusive of any tachycardia, are in the minority. The fibrillation-only patient typically experiences far fewer arrhythmia episodes than do patients with VT or supraventricular tachycardia (SVT). Although some patients present with fibrillation as the only documented or induced arrhythmia, many of these same patients had their VF episodes initiated by VT or have subsequent tachycardia episodes. About a third of the patients with ICDs implanted for cardiac arrest develop spontaneous monomorphic VTs and the vast majority are pace terminable.1


Ventricular Tachycardia Ventricular Fibrillation Cycle Length Implantable Cardioverter Defibrillator Reentrant Circuit 
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  1. 1.
    Mitra RL, Hsia HH, Hook BG, et al. Efficacy of antitachycardia pacing in patients presenting with cardiac arrest. PACE 1995;18:2035–2040.PubMedCrossRefGoogle Scholar
  2. 2.
    Newman DM, Lee MA, Herre JM, et al. Permanent antitachycardia pacemaker therapy for ventricular tachycardia. PACE 1989;12:1387–1395.PubMedCrossRefGoogle Scholar
  3. 3.
    Hardage ML, Sweeney MB, Automatic Tachycardia Terminating Burst Pacemakers, The Third Decade of Cardiac Pacing. Mount Kisco, New York, Futura Publishing, 1982 pp 293–307.Google Scholar
  4. 4.
    Abildskov JA, Lux KL. Mechanisms in the interruption of reentrant tachycardia by pacing. J Electrocard 1995;28:107–114.CrossRefGoogle Scholar
  5. 5.
    Waxman HL, Cain ME, Greenspan AM, et al. Termination of ventricular tachycardia with ventricular stimulation: salutary effect of increased current strength. Circulation 1982;65:800–804.PubMedCrossRefGoogle Scholar
  6. 6.
    Gardner MJ, Waxman HL, Buxton AE, et al. Termination of ventricular tachycardia. Evaluation of a new pacing method. Am J Cardiol 1982;50:1338–1345.PubMedCrossRefGoogle Scholar
  7. 7.
    Fisher JD, Kim SG, Waspe LE, et al. Mechanisms for the success and failure of pacing for termination of ventricular tachycardia: Clinical and hypothetical considerations. PACE 1983;6:1094–1105.PubMedCrossRefGoogle Scholar
  8. 8.
    Fisher JD, Johnston DR, Kim SG. Implantable pacers for tachycardia termination: stimulation techniques and long-term efficacy. PACE 1986;9:1325–1333.PubMedCrossRefGoogle Scholar
  9. 9.
    Rosenqvist M. Pacing techniques to terminate ventricular tachycardia. PACE 1995;18:592–598.PubMedCrossRefGoogle Scholar
  10. 10.
    Heisel A, Neuzner J, Himmrich E, et al. Safety of antitachycardia pacing in patients with implantable cardioverter defibrillators and severely depressed left ventricular function. PACE 1995;18:137–141.PubMedCrossRefGoogle Scholar
  11. 11.
    Porterfield JG, Porterfield LM, Smith BA, et al. Conversion rates of induced versus spontaneous ventricular tachycardia by a third generation cardioverter defibrillator. The Ventak PRx phase 1 investigators. PACE 1993;16:170–173.PubMedCrossRefGoogle Scholar
  12. 12.
    Pinski SL, Fahy GJ. The proarrhythmic potential of implantable cardioverter-defibrillators. Circulation 1995;92:1651–1664.PubMedCrossRefGoogle Scholar
  13. 13.
    Catanzariti D, Pennisi V, Pangallo A, et al. Efficacy and safety of antitachycardia pacing in ICD patients: analysis of two-years followup. Eur JCPE 1995;5:248–252.Google Scholar
  14. 14.
    Pacifico A, Nasir N, Doyle T, et al. Safety and efficacy of antitachycardia pacing with a new third generation implantable cardioverter defibrillator, XV Congress of the European Society of Cardiology, 1993.Google Scholar
  15. 15.
    Jackman WM, Zipes DP. Low-energy synchronous cardioversion of ventricular tachycardia using a catheter electrode in a canine model of subacute myocardial infarction. Circulation 1982;66:187.PubMedCrossRefGoogle Scholar
  16. 16.
    Connelly DT, Cardinal D, Foley L, et al. Is routine pre-discharge testing necessary for patients with implantable cardioverter-defibrillators? PACE 1996;19:614. (abstract)CrossRefGoogle Scholar
  17. 17.
    Hammill SC, Packer DL, Stanton MS, et al. Termination and acceleration of ventricular tachycardia with autodecremental pacing, burst pacing, and cardioversion in patients with an implantable cardioverter defibrillator. PACE 1995;18:3–10.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1996

Authors and Affiliations

  • Michael L. Hardage
  • Michael B. Sweeney

There are no affiliations available

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