Peters R W, Shafton E, Frank S, Thomas A N, Scheinman M M
Ann Intern Med. 1978 Jan;88(1):17-22. doi: 10.7326/0003-4819-88-1-17.
Seven patients with either recurrent paroxysmal supraventricular tachycardia (five), alternatinng bradycardiatachycardia (one), or ventricular tachycardia (one) underwent insertion of permanent radiofrequency-triggered pacemakers. Follow-up evaluation (36 +/- 24 months, mean +/- SD) revealed that arrhythmias were well controlled in five of seven patients, although three of the five required medication to decrease frequency of arrhythmias. Overdrive pacing was ineffective in one patient with Wolff-Parkinson-White syndrome who had recurrent bouts of atrial fibrillation or atrial flutter. One additional patient with ventricular tachycardia became refractory to overdrive atrial pacing. These studies document the long-term effectiveness of radiofrequency pacemakers in some patients with recurrent refractory arrhythmias. Careful patient selection and electrophysiologic studies are mandatory before implantation of a permanent radiofrequency pacemaker. Physicians must be aware of both the benefits and possible limitations of radiofrequency pacemakers in order to choose between pacemaker versus surgical intervention in patients with cardiac arrhythmias refractory to standard drug therapy.
7例复发性阵发性室上性心动过速（5例）、交替性心动过缓-心动过速（1例）或室性心动过速（1例）患者接受了永久性射频触发起搏器植入术。随访评估（平均36±24个月，均值±标准差）显示，7例患者中有5例心律失常得到良好控制，尽管这5例中有3例需要药物治疗以降低心律失常的频率。对于1例患有预激综合征且反复发生房颤或房扑的患者，超速起搏无效。另有1例室性心动过速患者对超速心房起搏变得难治。这些研究证明了射频起搏器对一些复发性难治性心律失常患者的长期有效性。在植入永久性射频起搏器之前，必须仔细选择患者并进行电生理研究。医生必须了解射频起搏器的益处和可能的局限性，以便在对标准药物治疗无效的心律失常患者中选择起搏器治疗还是手术干预。
