Rate-related accelerating (autodecremental) atrial pacing for reversion of paroxysmal supraventricular tachycardia. 1982

A Nathan, and K Hellestrand, and D Ward, and R Spurrell, and J Camm

Twenty consecutive patients with paroxysmal intra A-V nodal or atrio-ventricular tachycardia had a new tachycardia reversion pacing modality evaluated during routine electrophysiological study. The pacing was controlled by a micropressor interfaced with a stimulator connected to a right atrial pacing electrode. On detection of tachycardia the first pacing cycle interval is equal to the tachycardia cycle length minus a decrement value D. Each subsequent pacing cycle is further reduced by the same value of D, thus accelerating the pacing burst until a plateau of 100 beats/min faster than tachycardia (with an absolute lower limit of 275 beats/min) is reached. Seven different values of D (2, 4, 8, 16, 24, 34, 50 msec) were assessed in combination with three different durations of pacing P (500, 5000 msec). With P:500, only 2/20 tachycardias were terminated, but with P:1000, 16/20 were terminated. With P:5000 all were terminated and the combination successful in all patients was P:5000 and D:16. No unwanted arrhythmias were induced. In contrast, competitive constant rate overdrive atrial pacing accomplished tachycardia termination in all cases, but in four instances resulted in atrial flutter or fibrillation. Autodecremental pacing, which tends to avoid stimulation in the vulnerable period, allowed safe and successful termination of all tachycardias evaluated in this study.

UI MeSH Term Description Entries
D008297 Male Males
D008838 Microcomputers Small computers using LSI (large-scale integration) microprocessor chips as the CPU (central processing unit) and semiconductor memories for compact, inexpensive storage of program instructions and data. They are smaller and less expensive than minicomputers and are usually built into a dedicated system where they are optimized for a particular application. "Microprocessor" may refer to just the CPU or the entire microcomputer. Computers, Personal,Microprocessors,Computer, Personal,Microcomputer,Microprocessor,Personal Computer,Personal Computers
D010138 Pacemaker, Artificial A device designed to stimulate, by electric impulses, contraction of the heart muscles. It may be temporary (external) or permanent (internal or internal-external). Cardiac Pacemaker, Artificial,Artificial Cardiac Pacemaker,Artificial Cardiac Pacemakers,Artificial Pacemaker,Artificial Pacemakers,Cardiac Pacemakers, Artificial,Pacemaker, Artificial Cardiac,Pacemakers, Artificial,Pacemakers, Artificial Cardiac
D002304 Cardiac Pacing, Artificial Regulation of the rate of contraction of the heart muscles by an artificial pacemaker. Pacing, Cardiac, Artificial,Artificial Cardiac Pacing,Artificial Cardiac Pacings,Cardiac Pacings, Artificial,Pacing, Artificial Cardiac,Pacings, Artificial Cardiac
D004594 Electrophysiology The study of the generation and behavior of electrical charges in living organisms particularly the nervous system and the effects of electricity on living organisms.
D005069 Evaluation Studies as Topic Works about studies that determine the effectiveness or value of processes, personnel, and equipment, or the material on conducting such studies. Critique,Evaluation Indexes,Evaluation Methodology,Evaluation Report,Evaluation Research,Methodology, Evaluation,Pre-Post Tests,Qualitative Evaluation,Quantitative Evaluation,Theoretical Effectiveness,Use-Effectiveness,Critiques,Effectiveness, Theoretical,Evaluation Methodologies,Evaluation Reports,Evaluation, Qualitative,Evaluation, Quantitative,Evaluations, Qualitative,Evaluations, Quantitative,Indexes, Evaluation,Methodologies, Evaluation,Pre Post Tests,Pre-Post Test,Qualitative Evaluations,Quantitative Evaluations,Report, Evaluation,Reports, Evaluation,Research, Evaluation,Test, Pre-Post,Tests, Pre-Post,Use Effectiveness
D005260 Female Females
D006325 Heart Atria The chambers of the heart, to which the BLOOD returns from the circulation. Heart Atrium,Left Atrium,Right Atrium,Atria, Heart,Atrium, Heart,Atrium, Left,Atrium, Right
D006352 Heart Ventricles The lower right and left chambers of the heart. The right ventricle pumps venous BLOOD into the LUNGS and the left ventricle pumps oxygenated blood into the systemic arterial circulation. Cardiac Ventricle,Cardiac Ventricles,Heart Ventricle,Left Ventricle,Right Ventricle,Left Ventricles,Right Ventricles,Ventricle, Cardiac,Ventricle, Heart,Ventricle, Left,Ventricle, Right,Ventricles, Cardiac,Ventricles, Heart,Ventricles, Left,Ventricles, Right
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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