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Circulation. 1976;53:176-181

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Circulation, Vol 53, 176-181, Copyright © 1976 by American Heart Association

ARTICLES

Ventricular paired pacing to control rapid ventricular heart rate following open heart surgery. Observations on ectopic automaticity. Report of a case in a four-month-old patient

AL Waldo, E Krongrad, J Kupersmith, OR Levine, FO Bowman Jr and BF Hoffman

An unusual case is presented in which an atrioventricular (A-V) junctional tachycardia at a rate of 285 beats/min developed in the immediate postoperative period following surgical repair (a Mustard procedure) of transposition of the great vessels in a four-month-old infant. With that heart rate the systolic blood pressure bacame 35-40 mm Hg and urinary output ceased. Ventricular paired pacing was employed successfully to halve the mechanically effective ventricular rate. This resulted in a clinically effective blood pressure and return of normal urinary output. The clinical course of the A-V junctional tachycardia, plus its response to several interventions, suggested that the mechanism of the A-V junctional tachycardia was automatic rather than re-entrant. The study demonstrates that ventricular paired pacing for the control of cardiac arrhythmias is a useful clinical technique in selected cases.


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 ANGIOLOGYHome page
A. L. Waldo, V. J. Plumb, J. G. Arciniegas, R. W. Henthorn, and S. H. Zimmern
Verapamil Therapy in the Treatment of Supraventricular Arrhythmias Following Open Heart Surgery
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I. WIENER
Pacing Techniques in the Treatment of Tachycardias
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