Patient-activated transvenous cardiac stimulation for the treatment of supraventricular and ventricular tachycardia.

Recurrent, drug-refractory sustained tachycardias present a difficult management problem. After invasive electrophysiologic study and extensive antiarrhythmic drug testing, a permanent transvenous lead system and radiofrequency stimulator that required patient activation for burst pacing were implanted in eight patients with refractory ventricular tachycardia. In a follow-up period of 2 to 28.5 months (mean 12) each patient has successfully terminated multiple episodes of recurrent tachycardia without complication. This therapeutic approach has allowed a reduction in antiarrhythmic drug dosage and adverse effects, has obviated the need for frequent hospital admissions resulting from recurrent tachycardia, and has met with excellent patient acceptance.