Clinical experience and long-term results of antitachycardia pacemakers in patients with supraventricular tachycardia]

Patients with episodes of recurrent paroxysmal supraventricular tachycardia, refracted to different pharmacologic therapies, can be treated with automatic antitachycardia pacemakers. Long term results of 8 patients (6 females and 2 males), mean age 49.8 +/- 12.7 years, are presented. There were implanted an antitachycardia pacemaker 262-12 Intertach, with an electrode in right atrium. Electrophysiologic study showed a node reentry mechanism in 6 cases due to AV node functional dissociation; one case of accessory concealed pathway and other case with a double accessory pathway was undetected in the electrophysiologic study and it was the unique case in which the pacemaker was explanted due to their inefficiency. Every tachycardia were orthodromic with narrow QRS wave and mean cycle was 361 +/- 23 msec (range 310-400 msec). One case had two types of tachycardia, one with narrow QRS wave and other wide QRS wave tachycardia and different length of cycle what reduced to detect a previously double pathway. A reoperation was necessary in one case due to an electrode displacement and, finally, another one needed a reprogramming auricular sensitivity. Mean time follow-up was more than 2 years. Seven patients have sinusal rhythm without drugs and they have 6 months follow-up with a better quality of life, less hospital incomes and medical cares.