WITH THE lengthening of life expectancy, it is anticipated that an increasing number of patients with severe cardiac disease will be considered for surgical excision of coincidental malignant neoplasia. In patients with serious cardiac arrhythmias who must undergo major cancer surgery, the control of heart rate and the maintenance of an adequate cardiac output are of paramount importance if the hazards of renal, cerebral, and myocardial anoxia are to be avoided.
Cardiac output studies1 in patients with fixed, slow, heart rates associated with complete heart block or disturbances of sino-atrial node activity have shown that the accompanying low cardiac outputs are due, primarily, to the bradycardia. In most patients the cardiac output returned towards normal by artificial pacing at rates of 60 to 70 beats per minute. The use of this technique might thereby lessen the risk of major surgery in patients with these types of arrhythmias.
Kimball JT, Navab A, LaDue JS. Surgery of the Colon in a Patient With Adams-Stokes Disease: Use of an Intracardiac Electrode Pacer. JAMA. 1965;192(13):1166–1168. doi:10.1001/jama.1965.03080260054022
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