Abstract
Five patients aged between 27 and 48 years were referred for investigation of recurrent paroxysmal tachycardias. Electrophysiological studies revealed concealed ventriculoatrial accessory pathways in two patients, possible atrionodal pathways in two patients and dual intranodal pathways in one patient. During electrophysiological study, particular attention was paid to methods of terminating tachycardia by pacing techniques including single or double atrial and ventricular extrastimuli, atrial or ventricular underdrive, atrial overdrive pacing, and in two patients, rapid ventricular pacing. 'Autodecremental' atrial pacing was employed in all five patients and autodecremental ventricular pacing in two patients. This system is controlled by a microprocessor interfaced with a stimulator. When tachycardia of a cycle length less than 375 ms is sensed the system initiates pacing sequences. The initial stimulus is introduced at an interval less than the tachycardia cycle determined by a preset decremental value D. Each subsequent pacing interval is reduced by the value of D resulting in a gradual acceleration of pacing. The total duration of pacing is limited by the value of the pacing period (P). The final pacing rate is determined b...Continue Reading
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