Thirty-six patients, 6 to 88 years of age, with complete heart block had surgical implantation of internal electric pacemakers. Asynchronous pacers were used in 27 patients and synchronous units in nine. The average age at the time of surgery was 67 years. Severe coexisting disease, including congestive heart failure, azotemia, diabetes, or hypertension, was present in 26 patients. There was one operative death (2.7%), and six patients (16.7%) died subsequently. Mechanical pacemaker failures occurred in 25% and probably resulted in one fatality. A comparison of results in patients with syncopal histories who were treated medically and surgically reveals a 50% mortality at 42 months in the medically managed group and a 17% mortality at 37 months in the surgically managed patients. The symptomatic results warrant the use of pacemakers in the treatment of complete heart block.
INITIAL SUCCESS with implantable electrical pacemakers in the treatment of complete heart block has
Howard L. Gadboys, B. George Wisoff, Robert S. Litwak. Surgical Treatment of Complete Heart BlockAn Analysis of 36 Cases. JAMA. 1964;189(2):97–102. doi:10.1001/jama.1964.03070020025005