• Can Med Assoc J · Sep 1964

    INDICATIONS FOR TREATMENT OF COMPLETE ATRIOVENTRICULAR DISSOCIATION.

    • P ALLEN, R ROBERTSON, and W G TRAPP.
    • Can Med Assoc J. 1964 Sep 5; 91: 547-52.

    AbstractFOR PURPOSES OF CORRECT TREATMENT IT IS IMPORTANT TO RECOGNIZE THAT PATIENTS WITH COMPLETE ATRIOVENTRICULAR DISSOCIATION FALL INTO THREE GROUPS: Group I-established third-degree heart block with and without Stokes-Adams attacks; Group II-periodic third-degree heart block with and without Stokes-Adams attacks; Group III-established third-degree heart block with cardiac failure. Most patients in Group I present no technical problems when a pacemaker is implanted. In Group II it is advisable to insert a temporary intracardiac catheter electrode and maintain a rate of 60 to 64 during the periods of third-degree heart block. Sudden reversion, in this group, from sinus rhythm can be fatal. Group III patients will often require a pacemaker set in excess of 74 beats until they are free of cardiac failure. Fifteen of 20 patients with complete atrioventricular dissociation showed marked functional improvement after insertion of a pacemaker. The development, in our laboratory, of a 4'' portable pacemaker impulse detector has been invaluable in locating the cause of failure in an implanted pacemaker.

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