Ventricular tachycardia and fibrillation with implanted electrical pacemakers.

The treatment for patients with Stokes-Adams attacks complicating complete heart block now includes implantation of electrical pacemakers (Elmqvist and Senning, 1960; Glenn et al., 1959; Simpson et al., 1962). With increasing clinical experience, complications of this form of treatment are becoming more apparent. These include component failure with resultant inadequate stimulation (Chardack, Gage, and Greatbatch, 1961; Zoll et al., 1961; Elmqvist et al., 1963), or ventricular tachycardia and fibrillation with normal pacemaker function (Elmqvist et al., 1963; Portal et al., 1962; Dressler, 1964; A. Leatham and J. G. Davies, 1964, personal communication). Dressler (1964) reviewed ventricular arrhythmias in patients with normally functioning pacemakers and considered that a slow rate of stimulation was the underlying cause of these arrhythmias. We report 3 patients with recurrent ventricular tachycardia and fibrillation in the presence of normal pacemaker function.