Abstract
AbstractPermanent transvenous pacing of the heart for control of both rate and rhythm has achieved widespread acceptance in the treatment of heart block. It is now performed in adults of any age group, and there are no special contraindications. Data are presented on the results of 122 transvenous pacemaker implantations from one to three years after operation. The average age of the patients was 68, and 38 of them were over 75 years old. Episodic sinus arrest or asystole in patients with otherwise adequate cardiac rates can be detected by continuous electrocardiographic monitoring and treated by implantation of demand‐type pacemakers. Asynchronous units now are used only in very elderly patients with stable complete heart block.Displacement of the catheter has been the major problem; if recurrent, it is managed by direct epicardial insertion of the pacemaker leads through an extrapleural approach to the heart. The longevity of the power‐pack components and the battery still falls short of the manufacturers' claims. This emphasizes the need for establishment of pacemaker clinics so that sudden failure of pacemakers can be prevented.
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