Treatment of paroxysmal nodal tachycardia by dual demand pacemaker in the coronary sinus.
A patient with refractory paroxysmal atrioventricular nodal re-entrant tachycardia had required direct current cardioversion to terminate attacks on 83 occasions. A dual demand pacemaker was implanted to sense and interrupt attacks of tachycardia automatically. The pacing electrode was positioned in the proximal coronary sinus near to the atrioventricular node; a site from which fixed rate underdrive pacing successfully interrupted attacks throughout a trial period of one week, with a lead left in this position on a temporary basis. Complete control of the arrhythmia was obtained in the six months after pacemaker implantation.
D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D003331:Coronary Vessels; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D013614:Tachycardia, Paroxysmal / Q000628:therapy*