ANTITACHYCARDIA PACING

Patients who have attempted repair of congenital heart disease often d evelop bradycardia and tachycardias postoperatively. The two dysrhythm ias each make treatment of the other more difficult. Pacing is the onl y modality that addresses both brady- and tachycardias, without advers ely influencing the other. Most postoperative tachycardias are reentra nt, and thus uniquely susceptible to overdrive pacing. Usually an atri al single lead system is used. The patients most commonly encountered are those with extensive atrial surgery, such as atrial septal defect (ASD) repair, Mustard and Senning repair of d-transposition, and the v arious types of Fontan operations. The results are excellent for ASD r epair and postoperative transposition, but only fair for postoperative Fontan patients.