Termination of atrial flutter and atrial tachycardia with rapid atrial stimulation

• Published in: Angiology Vol. 26; no. 11; p. 784
• Main Authors: Pittman, D E, Gay, T C, Patel, I I, Joyner, C R
• Format: Journal Article
• Language: English
• Published: United States 01.12.1975
• Subjects: Aged; Atrial Flutter - etiology; Atrial Flutter - therapy; Cardiac Pacing, Artificial; Coronary Artery Disease - complications; Electric Countershock; Electrocardiography; Female; Heart Atria - physiopathology; Humans; Male; Middle Aged; Postoperative Complications - therapy; Tachycardia, Supraventricular - etiology; Tachycardia, Supraventricular - therapy
• ISSN: 0003-3197
• DOI: 10.1177/000331977502601102

The results in this series of fifty-seven patients confirms the safety and reliability of rapid atrial stimulation to terminate atrial flutter and atrial tachycardia. Transthoracic wires implanted at thoracotomy or transvenously placed atrial electrodes can be used for the confident intracardiac electrocardiographic diagnosis of tachyarrhythmias and for atrial stimulation. Our experience represents the second largest reported series of patients to undergo cardioversion by this method. In all but five of fifty-seven patients either the atrial tachyarrhythmia was converted to normal sinus rhythm or the flutter-tachycardia was terminated with resultant atrial fibrillation. In forty-three patients sinus rhythm was eventually re-established after atrial stimulation. Various aspects of rapid atrial stimulation, including it's preference over precordial shock, have been discussed. We feel particular consideration should be given cardioversion by rapid atrial stimulation in patients with possible digitalis toxicity and in all patients who have atrial flutter, atrial tachycardia, or junctional tachycardia after open heart surgery.