Overdrive Pacing for Ventricular Tachyarrhythmias: A Reassessment

Abstract

Overdrive pacing was used for many years to prevent ventricular tachycardia and there are many reports of its effectiveness. Nevertheless, the use of overdrive pacing for most types of ventricular tachyarrhythmia has been abandoned. One notable exception is torsades de pointes, in which interventions that increase heart rate, including pacing, at least temporarily protect against recurrence. Overdrive may work by narrowing dispersion of ventricular refractoriness, and measurement of the latter could provide a marker to selectively apply overdrive pacing, thus increasing its usefulness.