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Article
December 20, 1958

ASYSTOLE COMPLICATING ACUTE MYOCARDIAL INFARCTION: SURVIVAL WITH THE AID OF A CARDIAC PACEMAKER AND INTRAVENOUS ADMINISTRATION OF ISOPROTERENOL

Author Affiliations

Chicago

From the Department of Medicine and the Cardiovascular Department of the Medical Research Institute, Michael Reese Hospital.

JAMA. 1958;168(16):2124-2127. doi:10.1001/jama.1958.63000160001010
Abstract

Since the development by Zoll1 of an external cardiac pacemaker capable of producing effective ventricular contractions by transthoracic electric stimulation many cases of asystole have been successfully treated with the aid of this device alone or in combination with intravenous administration of isoproterenol (Isuprel) hydrochloride.2 The majority of the reported cases have been those of chronic atrioventricular block with Stokes-Adams disease. Recently we had opportunity to apply this regimen to a patient in whom an advanced second degree atrioventricular block with Stokes-Adams attacks developed acutely in the course of a myocardial infarct. (The term "advanced second degree atrioventricular block" is applied to cases in which several successively dropped beats initiate atrioventricular nodal escape and dissociation with or without ventricular captures.3) To our knowledge this is the first such case with survival treated in this manner. Continuous monitoring of the rapidly changing cardiac mechanism in conjunction with automatic

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