Patient-activated transvenous cardiac stimulation for the treatment of supraventricular and ventricular tachycardia

Recurrent, drug-refractory sustained tachycardias present a difficult management problem. After invasive electrophysiologic study and extensive antiarrhythmic drug testing, a permanent transvenous lead system and radiofrequency stimulator that required patient activation for burst pacing were implanted in eight patients with refractory Supraventricular tachycardia and in nine patients with refractory ventricular tachycardia. In a follow-up period of 2 to 28.5 months (mean 12) each patient has successfully terminated multiple episodes of recurrent tachycardia without complicatlon. This therapeutic approach has allowed a reduction in antiarrhythmic drug dosage and adverse effects, has obviated the need for frequent hospital admissions resulting from recurrent tachycardia, and has met with excellent patient acceptance.