Fisher J D, Cohen H L, Mehra R, Altschuler H, Escher D J, Furman S
Am Heart J. 1977 May;93(5):658-68. doi: 10.1016/s0002-8703(77)80018-5.
The place of pacemakers in the treatment of tachyarrhythmias has expanded far beyond the initial role in the brady-tachy syndrome, of providing a "minimum guaranteed rate" while medications suppress the tachycardia. Techniques have been developed for prevention, termination, and duplication of a patient's spontaneous tachycardia under safe catheterization laboratory conditions. Combined with accumulating information about the normal responses to electrophysiologic stresses, these techniques have led to a new dimension in arrhythmia control. Most tachycardias previously felt to be refractory can be controlled after serial electrophysiologic-pharmacologic testing, during which sequential pharmacologic and pacer regimens are tested until a combination is found which prevents induction of tachycardias, and/or a pace mode is found which reliably terminates the tachycardia. Use of such an approach reduces hospital admissions and referral for surgery, and eliminates prolonged hospitalization for assessment of therapy in patients with infrequent but potentially lethal spontaneous tachycardias.
起搏器在治疗快速性心律失常方面的作用已远远超出了其在快慢综合征中的最初作用，即在药物抑制心动过速时提供“最低保证心率”。已经开发出了在安全的导管实验室条件下预防、终止和复制患者自发性心动过速的技术。结合对电生理应激正常反应的不断积累的信息，这些技术为心律失常的控制带来了新的维度。大多数以前被认为难治的心动过速在进行系列电生理药理学测试后都可以得到控制，在此过程中依次测试药物和起搏器治疗方案，直到找到一种能预防心动过速诱发的组合，和/或找到一种能可靠终止心动过速的起搏模式。使用这种方法可减少住院次数和手术转诊，并消除了因偶发但可能致命的自发性心动过速患者进行治疗评估而导致的长期住院。
