Robert H. Goetz, M.D.
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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
Goetz RH. Pacing on Demand in Atrioventricular Conduction Disturbances of the Heart.. Ann Intern Med. ;68:1155–1156. doi: 10.7326/0003-4819-68-5-1155_3
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Published: Ann Intern Med. 1968;68(5):1155-1156.
Cardiology, Rhythm Disorders and Devices.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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