Institution of Physiological Pacing Utilizing Preexisting Hardware

Six patients with ventricular inhibited pacemakers, who experienced adverse effects from loss of atrial contribution to cardiac output and loss of atrioventricular synchrony, were successfully converted to atrial demand (3 patients) and atrioventricular sequential systems (3 patients). The preexisting ventricular pulse generator was used for atrial pacing in 3 patients, and the preexisting ventricular leads were employed for atrioventricular sequential pacing in 3 patients. The advantages and potential risks of utilizing preexisting hardware for conversion of ventricular pacing into physiological pacing are discussed.