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December 1985

Progress in Cardiac Pacing: Part II

Author Affiliations

From the Division of Cardiology, San Francisco General Hospital, and the Departments of Medicine, San Francisco General Hospital and University of California, San Francisco.

Arch Intern Med. 1985;145(12):2238-2244. doi:10.1001/archinte.1985.00360120110018

Technologic innovations have made many forms of pacing therapy available to patients. Part I of this review1 discussed the design features and programming capabilities of currently available pulse generators. Part II will focus on the various modes of pacing and present guidelines for their clinical application. We will also outline future trends in pacemaker design, emphasizing the potential of antitachycardia pacing.

PACING MODES: DEFINITION, RATIONALE, INDICATIONS  In the 1980s, the clinician needs to be sufficiently knowledgeable about cardiac pacemakers to participate in the decision to prescribe a specific pacing mode for the patient. This decision is usually between noncompetitive ventricular pacing (VVI mode; Table 1) and dual-chamber systems. The choice is often made in the absence of controlled clinical trials comparing these modes in properly selected patients.

Single-Chamber Pacing Modes  The single-chamber noncompetitive pacemaker generators used most widely are those that inhibit their output on sensing a spontaneous signal (AAI

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