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(Circulation. 2003;108:e9002.)
© 2003 American Heart Association, Inc.

Cardiovascular News

Ruth SoRelle, MPH

Circulation Newswriter

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The Cardioverter-Defibrillator Conundrum: Sometimes You Turn the Pacemaker Off

Turning the pacemaker feature off or programming in the longest possible escape interval is probably the prudent course in patients with implanted cardioverter-defibrillators who have had pacemaker-induced tachycardia and have no symptoms indicating the need for a pacemaker, said German researchers in a report on a small, single-center study in this week’s issue of Circulation, the journal of the American Heart Association (Circulation. 2003;108:192–197.)

Scientists from the Medical Clinic at University Hospital in Mainz, Germany, enrolled 13 patients who had previously experienced pacemaker-induced tachycardia in 1 of 2 study arms. The patients in arm 1 had augmentation of the baseline frequency of the pacemaker to 60 beats per minute, and those in arm 2 had their pacemakers turned off. The patients were monitored for a year and then crossed over to the other arm of the study. Researchers were attempting to assess what led to the recurrence of the pacemaker-induced tachycardia.

During the period of the study, no pacemaker-induced tachycardia occurred in patients whose pacemaker function was turned off. However, in the group with pacemakers programmed to 60 beats per minute, pacemaker-induced tachycardia recurred in 5 of 6 patients. At the end of the study, 8 of the patients were monitored for a prolonged period of time with their pacemaker function off. Spontaneous episodes of ventricular tachycardia or fibrillation were observed in 5 patients, but no pacemaker-induced tachycardia was seen.

The authors noted: "The pathophysiology of PIT [pacemaker-induced tachycardia] is still unclear, and it will not be . . . [Full Text of this Article]