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November 20, 1967

Cardiac Pacemakers

JAMA. 1967;202(8):848-849. doi:10.1001/jama.1967.03130210222049

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Electronic pacemakers have been used clinically since 1952. The development of the direct myocardial electrode in 1957 and of the implantable cardiac pacemaker in 1958 allowed their use to be extended to managing most of the complications of heart-block. Physicians now face the problem of selecting those patients with cardiac conduction defects who should be managed with medical therapy alone and those who should have temporary or permanent pacemakers. They also are called upon to manage pacemaker complication and failures.

The book begins with an excellent review of the history of Adams-Stokes attacks and of electrical stimulation of the heart. The chapters on the etiology and clinical presentation of complete heart-block are well organized and carefully documented. The discussion of drug therapy is brief but takes up each of the major groups of drugs. The only controversial part of this section is the recommendation of isoproterenol ( Isuprel ) hydrochloride for prolonged