Abstract
observed that a critical rate of pacing was requiredto terminate atrial flutter. At the lower rates of pacing,continuation of the arrhythmia occurred immediately aftercessation of pacing. Their observations had important clinical implications, including the recommendation for systematic prophylactic implantation of electrodes during cardiacsurgical procedures to terminate arrhythmias by rapid pacing(3,4), A more complicated issue is the value of the rapidpacing technique to study mechanisms of arrhythmias. Waldoet al. (5) also suggested that the demonstration of transiententrainment supports reentry as the underlying mechanismof the arrhythmia. In this issue of the Journal. Waldo et al.(6) offer us a study of a unique case of ventricular tachycardia that could be transiently entrained and terminated byatrial pacing. Most important, the reentrant circuit could bereversed by rapid atrial pacing. In this article, we wouldlike to discuss some aspects of the phenomenon of entrainment and some of its implications.
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