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January 1967

Complete Heart BlockTreatment by Pedicle Grafting of the Sinoauricular Node to the Right Ventricle

Author Affiliations

From the Department of Surgery, University of Missouri, Columbia.

Arch Surg. 1967;94(1):90-95. doi:10.1001/archsurg.1967.01330070092019

THE SURGICAL implantation of electronic pacemakers to correct varying degrees of heart block has not met with unqualified success. Battery decay, hermetic seal leakage, electrode dislodgement, wire breakage, infection, and fatal arrhythmias have been but a few of the complications reported.1-4 Since the first pioneers introduced implantable cardiac pacemakers5-7 in the initial part of this decade, the incidence of such technical difficulties has been markedly reduced. Nevertheless, some of the earliest reports8-10 still stand to remind the surgeon that a very gross foreign body is being traumatically introduced into a precarious myocardial environment. The use of a naturally occurring conduction by-pass would seem to be fraught with less tribulation and provide a more reasonable approach to longterm survival in patients with medically intractable heart block.

Classical observations in the "heart-lung" preparations and later with the electrocardiogram enabled early students of cardiac function to state that seemingly normal

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