Although ventricular tachycardia frequently subsides spontaneously or after administration of lidocaine, procainamide hydrochloride, quinidine sulfate, or other drugs, or after precordial electric shock, sometimes the arrhythmia is refractory to all these forms of therapy and eventually terminates in uncontrollable ventricular fibrillation. Initially, an artificial pacemaker set at normal rates of 60 to 80 beats per minute was employed to prevent recurrent ventricular tachycardia and ventricular fibrillation in patients with heart-block and Adams-Stokes disease. Subsequently, Sowton and his associates1 and others introduced the technique of artificial internal pacing at rapid rates to control refractory, recurrent ventricular tachycardia and fibrillation in patients without heart-block. It was presumed that the rapid artificial pacemaker would "override" and thereby suppress the ectopic focus or foci responsible for the arrhythmia.
When such refractory ventricular tachycardia occurs in patients with acute myocardial infarction, and especially when the patients are within a coronary-care unit in which trained personnel