Antitachycardia Pacing, Cardioversion, and Defibrillation: From the Past to the Future

  • J. D. Fisher
  • S. Furman
  • S. G. Kim
  • K. J. Ferrick
  • J. A. Roth
  • J. Gross
  • R. F. Brodman


Nearly three decades ago, it was known that ventricular tachycardias in the presence of bradycardia could be prevented by pacing at physiologic rates [1–10]. Temporary and implanted pacers have long been used to prevent tachycardias by rate support or suppressing ventricular premature complexes (VPCs) and to terminate tachycardias using competitive stimulation. In the 1970s, implantable antitachycardia pacemakers became commercially available. That decade saw many new antitachycardia applications and an increased understanding of the mechanisms involved in tachycardia termination. It appeared that pacers would play a major role in the treatment of tachycardias. Pacing failed, however, to reach projections for many reasons: physicians often fail to recognize the benefits of temporary as well as permanent antitachycardia pacing; implanted units require frequent reprogramming, rapid ventricular responses can occur if atrial fibrillation is provoked; younger patients balked because of the “image” of pacing as a treatment for the elderly. The danger of accelerating ventricular tachycardia (VT) into ventricular fibrillation (VF) produced great reluctance to implant pacemakers for VT termination. The implantable cardioverter defibrillator (ICD) further relegated pacing for VT to the background.


Ventricular Tachycardia Implantable Cardioverter Defibrillator Supraventricular Tachycardia Atrial Pace Defibrillation Threshold 
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Copyright information

© Springer-Verlag Berlin Heidelberg 1992

Authors and Affiliations

  • J. D. Fisher
  • S. Furman
  • S. G. Kim
  • K. J. Ferrick
  • J. A. Roth
  • J. Gross
  • R. F. Brodman

There are no affiliations available

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