Clinical Long-Term Experiences with High Rate Antitachycardia Stimulation (Cybertach 60)

Summary

Several investigators have judged the burst overdrive pacing mode to be effective in tachycardia termination during right ventricular programmed stimulation. The aim of the study was to investigate the long-term results of burst overdrive pacing by means of an implanted, programmable burst pacemaker (Intermedics Cybertach 60) in the treatment of drug-refractory supraventricular (n = 3) and ventricular (n = 3) tachycardias. Therefore 6 patients were repeatedly controlled during a follow-up period of up to 3 years. In 4/6 patients the parameters of the burst stimulation had to be changed within the first 6 months after the implantation. All 6 patients needed an additional antiarrhythmic drug treatment for the tachycardia conditioning. Due to a significant reduction of the tachycardias and hospitalisations all patients could normalize their lives. In a 20 year old man the battieries ran out after a 2 year period of excellent antitachycardia function. The patient was hospitalised due to continuous burst pacing, even during sinus rhythm or premature ventricular beats.

In conclusion, long-term burst pacing in patients with recurrent supraventricular or ventricular tachycardias by means of implantable antitachycardia pacemakers is a helpful therapeutic alternative. Additional antiarrhythmic drug treatment and programmability of the antitachycardia device are necessary prerequisites for a successful long-term application.