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November 1955

External Electric Stimulation of the Heart in Cardiac Arrest: Unexpected Circulatory Arrest

Author Affiliations


From the Medical Research Department of the Beth Israel Hospital and the Department of Medicine, Harvard Medical School. National Heart Institute Trainee, National Institutes of Health, U. S. P. H. S. (Dr. Paul) and Research Fellow of the American Heart Association (Dr. Gibson).

AMA Arch Intern Med. 1955;96(5):639-653. doi:10.1001/archinte.1955.00250160081006

Stokes-Adams disease consists of attacks of cerebral ischemia in patients with atrioventricular heart block. The attacks are due to inadequate circulation resulting from very slow idioventricular rhythm, ventricular standstill, ventricular tachycardia, or ventricular fibrillation.1 Their manifestations include dizziness, syncope, prolonged unconsciousness, and convulsions, and they may end in death. At times the attacks may be frequent and severe. If the patient can survive such periods, however, he may live for many years without further episodes.2

Stokes-Adams attacks often require emergency resuscitation, and desperate measures may be necessary. Therapy is complicated by the unpredictable occurrence, frequency, and duration of the seizures. Drugs and cardiac puncture, the only therapy heretofore available, are dangerous and often ineffective.

We have developed a new therapeutic approach to this serious disease: an externally-applied cardiac pacemaker which stimulates the heart electrically, terminates ventricular standstill, and maintains an externally-paced ventricular rhythm for long periods. This approach