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(Chest. 1973;63:995-1001.)
© 1973 American College of Chest Physicians

Rapid Atrial Stimulation in the Treatment of Supraventricular Tachycardia

John W. Lister M.D., F.C.C.P.1; Arthur J. Gosselin M.D., F.C.C.P.2; David A. Nathan M.D., F.C.C.P.1; and S. Serge Barold M.R.A.C.P.3

1 Attending physician, Department of Medicine, Miami Heart Institute, Miami Beach, Fla.
2 Director, Cardiopulmonary Laboratory, Miami Heart Institute, Miami Beach, Fla.
3 Chief of Cardiology, The Genesee Hospital, and Assistant Professor of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, N.Y.

Rapid atrial stimulation (RAS) has been found to be therapeutically useful in the treatment of selected cases of supraventriculnr tachycardias (SVT). RAS may (1) immediately revert the SVT to normal sinus rhythm, (2) transiently convert the rhythm to atrial fibrillation which after a variable period usually converts spontaneously to normal sinus rhythm, (3) permmeat conversion of the rhythm to atrial fibrillation with the immediate slowing of the ventricular rate, or (4) in cases in which the tachycardia cannot be terminated and atrial fibrillation cannot be initiated, the ventricular rate may be slowed by increasing the atrial rate until second degree heart block occures. To date, there have been remarkably few deleterious side effects with RAS. Previous digitalis adminktration is not a contraindication to the procedure. Although RAS has been successfully used to terminate SVTs in the WPW syndrome, under most circumstances the procedure is contraindicated in patients with anomalous antrioventricular connections.






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