Pacemaker Treatment of Heart Block

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Abstract
The implanted cardiac pacemaker has become the standard method of treatment of heart block. In the short period of five or six years, improvement in engineering, materials, and components has made available a dependable pacemaker unit which can function for two or three years without reoperation. Improved surgical technique has also led to a simplified operative approach which we believe will improve the short- and long-term results of cardiac pacing. The Epicardial-Type Pacemaker The first type of implanted pacemaker which achieved wide application was the epicardial type. Myocardial electrodes were sewn into the epicardial surface of the left ventricle through a thoracotomy incision and the wires were brought down through a subcutaneous tunnel to the lower left part of the abdomen and attached to the generator which was implanted subcutaneously. In 1964 a review inThe Journal1indicated that this was a safe and life-saving procedure with minimal operative mortality

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