Nürnberg M, Biber B, Frohner K, Rabitsch C, Steinbach K
Third Medical Department (Cardiology), Wilhelminenspital, Vienna, Austria.
Pacing Clin Electrophysiol. 1989 Apr;12(4 Pt 1):537-41. doi: 10.1111/j.1540-8159.1989.tb02697.x.
Atrial burst pacing is an effective method of terminating supraventricular tachycardia. In the patient presented in this report, a Symbios 7008 pacemaker (Medtronic Inc., Minneapolis, MN, USA) was implanted for two reasons: (1) severe AV conduction defect (AH, 230 msec; HV, 150 msec) and bifascicular block following anterior myocardial infarction; and (2) paroxysmal atrial flutter. The conduction defect ruled out programming other than atrial burst in DDD mode. Activation of burst pacing required appropriate programming of the "tachycardia detection window" on the basis of the cycle length of the flutter waves. In the case reviewed, episodes of atrial flutter with variable cycle lengths of 230 to 280 msec necessitated reprogramming of the AV interval, the refractory period, and the upper rate interval. The use of an antitachycardia device in automatic mode may be limited by variations in tachycardia cycle length.
心房猝发起搏是终止室上性心动过速的一种有效方法。在本报告中所介绍的患者中，植入了一台Symbios 7008起搏器（美敦力公司，美国明尼阿波利斯，明尼苏达州），原因有两个：（1）前壁心肌梗死后严重的房室传导缺陷（AH，230毫秒；HV，150毫秒）和双分支阻滞；（2）阵发性心房扑动。传导缺陷排除了在DDD模式下进行除心房猝发之外的程控。猝发起搏的启动需要根据扑动波的周期长度对“心动过速检测窗”进行适当程控。在所回顾的病例中，心房扑动发作时扑动波周期长度在230至280毫秒之间变化，这就需要对房室间期、不应期和上限频率间期进行重新程控。自动模式下抗心动过速装置的使用可能会受到心动过速周期长度变化的限制。
