Document Detail

The effect of chronic atrial overdrive suppression pacing on the incidence of supraventricular tachyarrhythmias.
MedLine Citation:
PMID:  1473308     Owner:  NLM     Status:  MEDLINE    
Chronic overdrive suppression pacing has been suggested as an effective adjunctive method for reducing the incidence of cardiac tachyarrhythmias. Documentation of effectiveness during prolonged monitoring is lacking, however. To assess more accurately the long-term utility of this treatment modality for medically refractory supraventricular tachyarrhythmias (SVTs), 10 patients with atrially implanted Intermedics Intertach pacemakers were randomly assigned to either a low or a high bradycardia (back-up) pacing rate. SVT counts were performed during matching follow-up periods both at the initial rate and after rate crossover. The primary antitachycardia modality of this pacemaker (P mod) provides burst pacing to terminate tachycardia episodes, and P mod counters were utilized to quantitate SVT episodes. Tachycardia termination algorithms were programmed to "no restart" and were not changed during the study. The P mod use counter, therefore, reflected the number of discrete episodes of SVTs. Pacemaker implantation diagnoses include atrial flutter, concealed bypass tract, AV nodal reentry, intraatrial reentry, and Wolff-Parkinson-White associated tachycardia. Patient age was 59 +/- 18 yrs. The average pacemaker back-up low rate was 45.7 +/- 4 versus a back-up high rate of 85.1 +/- 2 beats/min. Follow-up was for 57.4 days +/- 33 days at the low rate and 57.3 days +/- 34 days at the high rate (r = 0.99). There was no difference in SVT incidence with a P mod usage of 98.4 +/- 106 at the low rate and 100.8 +/- 94 at the high rate (p = NS). In this blinded, randomized cross-over trial, chronic atrial overdrive suppression pacing did not reduce the overall incidence of SVT episodes during prolonged monitoring.
A H Shandling; R Crump; M Nolasco; L M Lorenz; C K Li
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical cardiology     Volume:  15     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  1992 Dec 
Date Detail:
Created Date:  1993-02-01     Completed Date:  1993-02-01     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  917-22     Citation Subset:  IM    
Memorial Heart Institute, Long Beach Memorial Medical Center, CA 90801-1428.
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MeSH Terms
Activities of Daily Living
Aged, 80 and over
Cardiac Pacing, Artificial / methods*
Electrocardiography, Ambulatory
Equipment Design
Follow-Up Studies
Middle Aged
Pacemaker, Artificial
Physical Exertion / physiology
Single-Blind Method
Tachycardia, Supraventricular / prevention & control*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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