Epicardial electrode implantation on both right and left ventricles using local anaesthesia

Experience with a simple method of epicardialintramural pacer lead implantation on either ventricle using local anaesthesia for long term cardiac pacing in cases of symptomatic heart block is presented. The report concerns 40 patients with 41 implants. The follow-up period was 6–19 months. There were 3 operative deaths. One of the deaths was coincidental and the other 2 were attributed to bad selection. Early electrode failure due to the development of an exit block occurred in 1 case; he has done well after his right ventricular electrode was transferred to the left ventricle through the same incision using local anaesthesia. There has been no late electrode failure. Nearly all the survivors have obtained excellent results. The distinct advantages offered by this technique of epicardial pacing are discussed. The modification which has been introduced in extending the scope of pacer lead implantation to the left ventricle has increased the usefulness of the technique. Left ventricular placement of the electrode assures better intramural pacing.