The Use of a Myocardial Electrode Inserted Percutaneously for Control of Complete Atrioventricular Block by an Artificial Pacemaker

¹ The Department of Surgery and Variety Club Heart Hospital, University of Minnesota Medical School.

1. A procedure to introduce percutaneously a myocardial electrode into the ventricular wall was developed.

2. Animal experimentation, with creation of complete and permanent atrioventricular block by placing stitches in the atrioventricular node and bundle through a right atriotomy under direct vision with the use of a pump-oxygenator, has shown the efficiency and the safety of this technique.

3. A technique for the percuntaneous insertion of the myocardial electrode in the humans is described. This method permits the effective control of complete heart block by use of the artificial pacemaker without the necessity of opening the chest to place an electrode.

4. The indications of the method are chiefly the control of complete heart block with very slow rates or episodes of ventricular standstill occurring for the first time in the postoperative course after the chest has been closed or in medical patients with the Stokes-Adams syndrome due to cardiac disease or drug therapy. The efficacy, safety, and easy applicability of this technique permits its use for emergency resuscitations.

5. The superiority of internal pacemaker stimulation over use of external electrodes or drug therapy (Isuprel) has been emphasized.

6. A lightweight transistor pacemaker has been developed which permits greater patient mobility and safety than the more cumbersome units available earlier.