[Non-invasive conversion of atrial flutter using an implanted double-chamber pacemaker].
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.
Unita Operativa di Elettrofisiologia ed Elettrostimolazione Cardiaca, Ospedale Infermi, Rimini.
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Sermasi
D000368:Aged; D001282:Atrial Flutter / Q000503:physiopathology / Q000628:therapy*; D004562:Electrocardiography; D004867:Equipment Design; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D019736:Prostheses and Implants
Conversione non invasiva del flutter atriale conseguita utilizzando il generatore bicamerale impiantato.