Long-term Prevention of Vagal Atrial Arrhythmias by Atrial Pacing at 90/Minute: Experience with 6 Cases (original) (raw)

Long-term prevention of vagal arrhythmias by atrial pacing at 90/niinute: Experience with 6 cases. Six palienis (5 men, 1 woman} with a history ranging irom 3-16 years of resistant vagal atrial arrhythmias wore treated by atrial pacing at a rate of 90/min. These patients have been followed up for an average of 5.5 years (range 2-11 yearsj with favorab/e resu/ts. The arrhythmias were characterized by daily or weekly attacks of typical alrial flutter and alriaJ fihrillation occurring mainly or excJusiveJy at night, al rest, or in the digestive periods in otherwise normal hearts of midd/e-aged patients (first attack between 25 and 54. mean 40J. The arrhythmias were resistant lo quinidine, and were usually aggravated by digitalis, beta-blockers and verapamiJ. Amiodarone is usually the only effective drug in this syndrome, but was not used before pacing in the 2 first cases, and was ineffective in the other 4 cases. Electrophysiologic studies confirmed the absence of sick sinus syndrome, and the close relationship belween a relative hradycardia and the onset ofthe arrhythmia. Atrial pacing alone totally controlled the arrhythmia in 1 patient; amiodarone was used in conjunction with pacing in 3 patients. In 1 patient (he improvement was clear but incomplete, and in 1 paUent permanent atrial fibrillation occurredshortly after pacemaker implantation.