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July 6, 1964

Lengthy Survival With Pacemaker

JAMA. 1964;189(1):67. doi:10.1001/jama.1964.03070010073028

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To the Editor:—  We have previously reported (Northwest Med61:166, 1962) on successful continuous electrical pacing of the heart by electrode implantation into the myocardium of a 63-year-old woman who had complete heart block. The impulse was supplied by an externally carried pacer. The only majoi complications were associated with breakage of connecting wires, which always led to recurrence of poorly tolerated idioventricular rhythm. At all other times, for 33 months, the patient was ambulatory and comfortable. Occurring around the implant sites were areas of extensive fibrosis (proved by autopsy) which interfered with ability of electrical impulses to stimulate myocardial contraction. The electrode was replaced surgically, and pacing once again worked perfectly. Postoperatively the patient never regained consciousness. The exact cause of death was not apparent nor ever established. We wish to emphasize, in view of the paucity of reports on long-term survival, that our patient could have reasonably

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