The implantable transvenous cardioverter: Long-term efficacy and reproducible induction of ventricular tachycardia

W. M. Miles, E. N. Prystowsky, J. J. Heger, D. P. Zipes

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

We followed 11 patients for 5 to 27 months (mean 14.9) after implantation of a permanent transvenous low-energy synchronized cardioverter to evaluate both long-term reproducibility of ventricular tachycardia (VT) induction via noninvasive programmed electrical stimulation with the cardioverter and efficacy of cardioversion. Induction and termination of VT were attempted at implantation and approximately every 3 months thereafter. All patients had coronary artery disease and were receiving antiarrhythmic drug therapy (amiodarone in eight). VT cycle length, morphology, and mode of induction were reproducible on multiple occasions in nine patients; clinical VT was induced inconsistently in two patients. Multiple VT episodes in five patients had one morphology, whereas two morphologies occurred in six patients. Synchronization of the shock within the QRS complex and right ventricular effective refractory periods determined via the cardioverter remained constant over the follow-up period. VT was terminated on every occasion in nine patients and on eight of nine occasions in one patient. Tachycardia was accelerated on three of five occasions in one patient. Consistently effective cardioversion energy (0.2 to 2.0 J) increased modestly in four patients. We conclude that (1) patients with inducible monomorphic VT usually have sustained VT sith similar characteristics inducible over a period of time and (2) cardioversion and sensing functions of the cardioverter remain relatively stable over time.

Original languageEnglish (US)
Pages (from-to)518-524
Number of pages7
JournalCirculation
Volume74
Issue number3
DOIs
StatePublished - Jan 1 1986

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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