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Abstracts |

Pacing on Demand in Atrioventricular Conduction Disturbances of the Heart.

Robert H. Goetz, M.D.
Ann Intern Med. 1968;68(5):1155-1156. doi:10.7326/0003-4819-68-5-1155_3
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Continuous cardiac pacing with totally implanted pulse generators has now become standard therapy for patients with complete heart block and Adams-Stokes syndrome. The pacemaker assumes complete control over ventricular conduction suppressing all spontaneous activity. However, in patients who go in and out of heart block, pacing by means of a continuous fixed rate pacemaker results in a competition between naturally induced stimuli and the pacemaker-produced beats for capture of the ventricular contraction. This results in a bizarre cardiac rhythm, tachycardias, and possibly ventricular fibrillation if a pacemaker beat should fall into the vulnerable period of the naturally induced beat. Recent

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