[Skip to Content]
Sign In
Individual Sign In
Create an Account
Institutional Sign In
OpenAthens Shibboleth
[Skip to Content Landing]
Article
June 1976

Permanent Atrial PacingEpicardial Approach—"Pinch-On" Electrodes

Author Affiliations

From the County General and Community Memorial Hospitals, Ventura, Calif.

Arch Surg. 1976;111(6):712-715. doi:10.1001/archsurg.1976.01360240092017
Abstract

• Atrial pacing, while recognized to have therapeutic indications, has not been easily accomplished because there have been no simple and reliable electrodes available. A short parasternal mediastinotomy provides sufficient exposure for easy application of "pinch-on" electrodes to the presenting fold of the right atrium. Special attention is given to the recording of electrical indexes of the pulse generator and electrodes (voltage threshold, calculated impedance, and intrinsic amplitude of the P wave) with testing apparatus, most of which is conveniently brought to the operating table. Less than ideal results are not accepted, and immediate replacement of the electrodes into adjacent areas of the atrial myocardium is performed with ease. Five patients have tolerated the procedure without complication. These electrodes and this operative procedure have proved to have been successful over a six-month term of observation.

(Arch Surg 111:712-715, 1976)

References
1.
Haft JI, Kowosky BD, Lau SH, et al:  Termination of atrial flutter by rapid electrical pacing of the atrium . Am J Cardiol 20:239-243, 1967.Article
2.
Wise JR Jr:  Patient-activated atrial pacing in the treatment of recurrent supraventricular tachycardia . Chest 65:212-215, 1974.Article
3.
Kramer DH, Moss AJ:  Permanent pervenous atrial pacing from the coronary vein . Circulation 62:427-436, 1970.Article
4.
Scheinman MM, Peters R, Hirschfield DS:  The sick sinus and ailing atrium . West J Med 121:473-481, 1974.
5.
Smyth NPD, Basu AP, Bacos JM, et al:  Permanent transvenous synchronous cardiac pacing . Chest 59:493-497, 1971.Article
6.
Haas JM, Strait GB:  Pacemaker-induced cardiovascular failure: Hemodynamic and angiographic observations . Am J Cardiol 33:295-299, 1974.Article
7.
Parsonnet V, Furman S, Smyth NPD:  Report of Inter-Society Commission for Heart Disease Resources: Implantable cardiac pacemakers: Status report and resource guideline . Circulation 50:A21-A25, 1974.
8.
Gibbons T, Duffin EG:  Xytron product performance verification report . Medtronic Inc 21:25, 1975.
9.
Irnich W:  State of the art in pacemaker therapy: Previous experience and tendencies in development . Herz/Kreisl 6:95-101, 1974.
10.
Hurzeler P, deCaprio V, Furman S:  Endocardial electrograms and pacer sensing , in Schaldach M, Furman S (eds): Advances in Pacemaker Technology . Berlin, Springer-Verlag, 307-316, 1975.
11.
Nusbaum M, Levit S:  Technique for permanent implantation of atrial pacemaker . Surgery 68:916-918, 1970.
12.
Silveman LF, Mankin HT, McGoon DC:  Surgical treatment of inadequate sinus mechanisms by implantation of a right atrial pacemaker electrode . J Thorac Cardiovasc Surg 55:264-270, 1968.
13.
Smyth NPD, Vasarhelyi L, McNamara W, et al:  A permanent transvenous atrial electrode catheter . J Thorac Cardiovasc Surg 58:773-782, 1969.
14.
Moss AJ, Rivers RJ, Kramer DH:  Permanent pervenous atrial pacing from the coronary vein: Long-term follow-up . Circulation 49:222-225, 1974.Article
15.
Perryman RA, Sealy WC:  Permanent atrial pacing: Improved methods of electrode implantation and therapeutic uses . Ann Thorac Surg 15:16-24, 1973.Article
16.
Calvin JW, Stemmer EA, Steedman RA, et al:  Clinical application of parasternal mediastinotomy . Arch Surg 102:322-325, 1971.Article
17.
Calvin JW, Zuber WF, Bilitch M, et al:  Parasternal mediastinal approach for permanent cardiac pacemaker implantation . Chest 68:405, 1975.
18.
Schechter DC:  The surgical management of tachydysrhythmias . Bull Am College Chest Physicians 14:37-42, 1975.
×