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October 7, 1968


JAMA. 1968;206(2):367-368. doi:10.1001/jama.1968.03150020083020

Though the term "electrical failure" is new, the phenomena that it comprises have been known for a long time. Disturbances of automaticity and conductivity have been viewed, however, not as a distinct type of failure, but as a complication of heart disease which may contribute to cardiac decompensation or cause instant death. Why, then, the recent separation into a category distinct from mechanical "pump" failure? Why the emphasis on electrophysiology?

The concept of electrical failure owes much—we suspect—to the success of electricity in resuscitation. Proximity of death adds dramatic impact to the concept. And, for patients resuscitated in coronary care units or for those whose lives depend on permanently implanted pacemakers, it is charged with poignancy.

Both as term and as concept, "electrical failure" is eminently useful. Emphasizing bioelectrical phenomena, it deepens interest in basic electrophysiologic mechanisms of cardiac performance; it sharpens sensitivity to warning signs of impending cardiac disaster;