Programming antitachycardia pacing for primary prevention in patients with implantable cardioverter defibrillators: results from the PROVE trial.

Objectives: the PROVE trial was designed to determine if antitachycardia pacing (ATP) is clinically beneficial for primary prevention in patients who have implantable cardioverter defibrillators (ICDs) or cardiac resynchronization therapy defibrillators (CRT-Ds).

Background: use of ICDs and CRT-Ds reduces mortality in patients with ventricular dysfunction and mild to moderate heart failure. However, in studies of the primary prevention population, shock-only ICDs are predominantly used, without ATP programming for less painful termination of ventricular tachycardia (VT).

Long-term changes in high-voltage impedance of defibrillating leads.

Background: The maturation of the high-voltage impedance (HVLI) of defibrillating leads has not been explored thoroughly. Since impedance influences the charge, current, and energy delivered to the heart in both fixed pulse-width and fixed tilt implantable cardioverter-defibrillator (ICD) waveforms, changes in HVLI might have an effect on the defibrillation threshold. This analysis examined the maturation of defibrillation lead HVLI.

Placement of a pacing lead at the inferior portion of the interatrial septum without special tools.

Introduction: Previous studies have suggested that, among septal sites, the inferior portion of the interatrial septum (IAS) is the most likely to prevent atrial fibrillation, though inserting an active fixation lead at this site can be tedious and time consuming. We describe a relatively straightforward technique to insert a lead at this site without special tools.

Method: We studied 117 consecutive patients (mean age = 76 +/- 8 years, 69% men) with ACC/AHA class I and II pacing indications and histories of paroxysmal or permanent atrial fibrillation, undergoing implantation of a dual chamber pacing system.

Transvenous dual site left ventricular pacing plus biventricular pacing for the management of refractory ventricular tachycardia.

This is a case report of a male patient with nonischemic cardiomyopathy who had severely depressed left ventricular systolic function and functional class III congestive heart failure (CHF). He also had left bundle branch block (LBBB) and recurrent ventricular tachycardia (VT). Though the patient's CFH functional class improved after implantation of a transvenous biventricular ICD system, recurrent VT episodes required the initiation of amiodarone.