Complete Heart Block

The constant and significant threat of sudden death in patients refractory to medical treatment for complete heart block, coupled with the enforced decreased activity associated with persistent bradycardia, can be relieved by the implantation of an electronic pacemaker. The operation for implantation in 17 patients has been well tolerated. All but two patients have experienced marked alleviation of their symptoms. Complications have included electrode wire disruption in four patients and pacemaker component failure in two patients. There has been one death ascribed to ventricular fibrillation three months following implantation. The concurrence of sinus rhythm and electrical pacemaking has been well tolerated when it has occurred. Measurement of peripheral arterial flow at varied ventricular rates appears to support the use of a fixed ventricular stimulation rate at about 70 beats per minute.