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1 Departments of Medicine and Cardiovascular Surgery, Hahnemann Medical College, Philadelphia, Penna.
Clinical experience with both fixed rate and demand pacing suggests that the latter mode should probably be utilized in patients with second degree or intermittent high grade A-V block. Instances of ventricular tachycardia and fibrillation following a propagated pacemaker beat, competition between sinus rhythm and fixed rate pacing, and rapid ventricular rates due to coupled ventricular premature systoles also suggest pertinent arguments in favor of demand pacing. Although it is probably too early to advise demand pacing for all patients, inferential reasoning from clinical experience is offered to identify more clearly the advantages of demand over fixed rate pacing.
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