Transvenous Atrial Pacing in the Treatment of Refractory Ventricular Irritability

Abstract

Case Studies1 May 1967Transvenous Atrial Pacing in the Treatment of Refractory Ventricular IrritabilityJOHN A. KASTOR, M.D., ROMAN W. DESANCTIS, M.D., F.A.C.P., J. WARREN HARTHORNE, M.D., F.A.C.P., GABRIEL H. SCHWARTZ, M.D.JOHN A. KASTOR, M.D., ROMAN W. DESANCTIS, M.D., F.A.C.P., J. WARREN HARTHORNE, M.D., F.A.C.P., GABRIEL H. SCHWARTZ, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-66-5-939 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAmong the most challenging and potentially fatal problems in medicine is that of repetitive ventricular tachycardia and ventricular fibrillation that cannot be suppressed with the usual antiarrhythmic drugs. When this problem arises in the course of complete atrioventricular (AV) block, it usually can be eliminated by pacing the ventricles at a rate that prevents ventricular ectopic activity from emerging (1).Recently Sowton, Leatham, and Carson (2) and Heiman and Helwig (3) have reported the successful use of rapid intracardiac pacing by means of electrodes positioned in either the right ventricle or right atrium to manage refractory ventricular tachyarrhythmias even in...References1. ZOLLLINENTHAL PMAJ: Long-term electric pacemakers for Stokes-Adams disease (editorial). Circulation 22: 341, 1960. CrossrefMedlineGoogle Scholar2. SOWTONLEATHAMCARSON EAP: The suppression of arrhythmias by artificial pacemaking. Lancet 2: 1098, 1964. CrossrefMedlineGoogle Scholar3. HEIMANHELWIG DFJ: Suppression of ventricular arrhythmias by transvenous intracardiac pacing. JAMA 195: 1150, 1966. CrossrefGoogle Scholar4. HARRISHURLBURTFLOYDORGAIN CWJCWLES: Percutaneous technic for cardiac pacing with a platinum-tipped electrode catheter. Amer. J. Cardiol. 15: 48, 1965. CrossrefMedlineGoogle Scholar5. KIMBALLKILLIP JTT: A simple bedside method for transvenous intracardiac pacing. Amer. Heart J. 70: 35, 1965. CrossrefMedlineGoogle Scholar6. PICK A: Manifestations of a vulnerable phase in the human heart, in Sudden Cardiac Death, edited by SURAWICZ, B., PELLEGRINO, E. D. Grune & Stratton, Inc., New York, 1964, p. 44. Google Scholar7. SELZERWRAY AHW: Quinidine syncope. Paroxysmal ventricular fibrillation occurring during treatment of chronic atrial arrhythmias. Circulation 30: 17, 1964. CrossrefMedlineGoogle Scholar8. LINENTHALZOLL AJPM: Prevention of ventricular tachycardia and fibrillation by intravenous isoproterenol and epinephrine. Circulation 27: 5, 1963. CrossrefMedlineGoogle Scholar9. PICKLANGENDORFKATZ ARLN: Depression of cardiac pacemakers by premature impulses. Amer. Heart J. 41: 49, 1951. CrossrefMedlineGoogle Scholar10. ROGELSTEIN SH: The duration of postpacing asystole in dogs with atrioventricular block. J. Thorac. Cardiov. Surg. 50: 438, 1965. CrossrefMedlineGoogle Scholar11. SOWTON E: Personal communication to the authors, 1966. Google Scholar12. HELWIG J: Personal communication to the authors, 1966. Google Scholar13. VOGELTABARIAVERILLBLOUNT JHKKHSG: A simple technique for identifying P waves in complex arrhythmias. Amer. Heart J. 67: 158, 1964. CrossrefMedlineGoogle Scholar14. NUTTERKELSER DOGA: The percutaneous intracavitary electrocardiogram in the diagnosis of arrhythmias. Ann. Intern. Med. 62: 706, 1965. LinkGoogle Scholar15. BURCHELL HB: Hidden hazards of cardiac pacemakers (editorial). Circulation 24: 161, 1961. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Boston, MassachusettsFrom the Departments of Medicine, Harvard Medical School, and the Massachusetts General Hospital (Cardiac Unit), Boston, Mass.This study was supported in part by training grant HE 5196-10, the U. S. Public Health Service, Washington, D. C.Dr. Kastor is a teaching fellow in medicine, Harvard Medical School, and a clinical and research fellow in medicine, Massachusetts General Hospital; and Dr. Schwartz is a fellow in medicine, Cornell University Medical College.Portions of this report were presented at the Regional Meeting of the American College of Physicians, Montreal, Quebec, Canada, November 11, 1966.Requests for reprints should be addressed to John A. Kastor, M.D., Cardiac Unit, Massachusetts General Hospital, Boston, Mass. 02114. 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ZIPES, M.D., BARRY FESTOFF, M.D., STEPHEN F. SCHAAL, M.D., CLYDE COX, M.D., WILL C. SEALY, M.D., ANDREW G. WALLACE, M.D.Paroxysmal Ventricular Fibrillation in Two Patients with HypomagnesemiaRefractory Paroxysmal Ventricular TachycardiaDOUGLAS P. ZIPES, M.D., EDWARD S. ORGAIN, M.D., F.A.C.P. 1 May 1967Volume 66, Issue 5Page: 939-945KeywordsElectrocardiographyHospital medicineMedical servicesPacemakersPatient advocacyPatientsRight ventricleTachycardiaVentricular fibrillationVentricular tachycardia Issue Published: 1 May 1967 PDF DownloadLoading ...