Marconi M, Sermasi S
Unita Operativa di Elettrofisiologia ed Elettrostimolazione Cardiaca, Ospedale Infermi, Rimini.
G Ital Cardiol. 1993 Jan;23(1):63-7.
The increasing sophistication of implantable pacemakers for treating both tachycardia and bradycardia has resulted in the ability to use the implanted device for more interventions other than simple pacing. The interruption of tachyarrhythmias has been attempted using special programmers which allow stimulation at different cycle lengths, even very short ones. We describe two cases in which neither antitachycardia device nor special equipment were used to terminate an atrial flutter. Two patients with Sick Sinus syndrome who had received DDD pacemaker, presented with a sustained atrial flutter. Pacers were set in AOO mode at the highest rate programmable (119 and 130 ppm, respectively) obtaining an underdrive atrial pacing (F-F rate was 280 ppm in both cases) which was able to convert the atrial flutter to sinus rhythm. The procedure was performed in the outpatient clinic. Our cases illustrate one of many potential applications of permanent pacemakers in noninvasive settings. We can conclude that when atrial flutter occurs in AAI or DDD pacemaker recipients, underdrive atrial pacing using the implanted pacemaker should always be attempted.
用于治疗心动过速和心动过缓的植入式起搏器日益复杂，这使得植入设备除了简单起搏外还能用于更多干预措施。人们已尝试使用特殊的程控仪来中断快速性心律失常，这种程控仪允许以不同的周期长度进行刺激，甚至是非常短的周期长度。我们描述了两例未使用抗心动过速设备或特殊设备而终止心房扑动的病例。两名患有病态窦房结综合征且植入了DDD起搏器的患者出现了持续性心房扑动。起搏器被设置为AOO模式，以最高可编程频率（分别为119次/分钟和130次/分钟）进行起搏，实现了超速抑制性心房起搏（两例患者的F - F频率均为280次/分钟），从而将心房扑动转为窦性心律。该操作在门诊进行。我们的病例说明了永久起搏器在非侵入性情况下的众多潜在应用之一。我们可以得出结论，当AAI或DDD起搏器植入者发生心房扑动时，应始终尝试使用植入式起搏器进行超速抑制性心房起搏。
