Role of the Pacemaker in the Therapy of Complete A-V Heart Block, Stokes-Adams Seizures and Episodes of Cardiac Arrest

Abstract

In the asymptomatic variety of complete A-V heart block (absence of syncopal attacks or congestive failure) no therapy is required to increase the ventricular rate. In the symptomatic variety (associated with syncopal attacks and or congestive failure) procedures are indicated to increase the ventricular rate. This may be accomplished by the use of sympathomimetic drugs (ephedrine, Isuprel) and or molar sodium lactate. Following operative correction of interventricular septal defects, complete A-V heart block occasionally occurs because of the interruption of the A-V conduction system. Heart failure and or Stokes-Adams seizures are frequent complications. In such instances the use of the pacemaker as a temporary expedient may be helpful in increasing the cardiac rate. The resulting increase in cardiac output will have a salutary effect on the congestive failure and will prevent Stokes-Adams seizures.