Portillo B, Medina-Ravell V, Portillo-Leon N, Maduro C, Mejias J, Berkovits B V, Castellanos A
Pacing Clin Electrophysiol. 1982 Nov;5(6):814-25. doi: 10.1111/j.1540-8159.1982.tb06562.x.
Programmable dual A-V sequential demand (DVI,MN) pacemakers were implanted in eight patients with recurrent or incessant, drug-refractory, A-V reciprocating tachycardias. This was done after intracardiac studies had identified a variety of electrogenetic mechanisms which include tachycardias involving Kent bundles, (manifest or concealed Wolff-Parkinson-White syndrome), nodoventricular (Mahaim) fibers, enhanced A-V node pathways (Lown-Ganong-Levine syndrome), and dual intranodal pathways. The antitachycardia features of the pacemaker were evaluated during the electrophysiological studies. No immediate postoperative complications occurred after implantation. Furthermore, during the follow-up periods (4 to 20 months), clinical assessment, ambulatory (Holter) monitoring and invasive (as well as noninvasive) evaluations have confirmed continuous effectiveness in recognizing and automatically terminating the tachycardias. Late pacemaker system malfunction has not occurred. The frequency of the tachycardias and the dosage of concomitantly-administered antiarrhythmic medications were significantly reduced. Furthermore, preliminary studies performed in our laboratory suggest that DVI,MN pacemakers may also be useful in certain types of intra-atrial reentry tachycardias coexisting with sinus node dysfunction.
八名患有复发性或持续性、药物难治性房室折返性心动过速的患者植入了可编程双房室顺序按需型（DVI，MN）起搏器。这是在心脏内研究确定了多种电发生机制后进行的，这些机制包括涉及肯特束的心动过速（显性或隐匿性预激综合征）、结室（Mahaim）纤维、房室结增强传导通路（Lown-Ganong-Levine综合征）和双结内传导通路。在电生理研究期间评估了起搏器的抗心动过速特性。植入后未发生即刻术后并发症。此外，在随访期（4至20个月）内，临床评估、动态（Holter）监测以及有创（和无创）评估均证实，该起搏器在识别并自动终止心动过速方面持续有效。未发生晚期起搏器系统故障。心动过速的发作频率以及同时服用的抗心律失常药物的剂量均显著降低。此外，我们实验室进行的初步研究表明，DVI，MN起搏器在某些与窦房结功能障碍并存的房内折返性心动过速类型中可能也有用。
