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Article
March 1960

The Use of an Internal Pacemaker in the Treatment of Cardiac Arrest and Slow Heart Rates: Preliminary Report

Author Affiliations

Philadelphia

From the Division of Cardiology, Philadelphia General Hospital, Philadelphia, The Robinette Foundation of the University of Pennsylvania, and Atronic Products, Inc., Philadelphia. This work was aided by grants from the Foundation for Cardiovascular Research, the U.S. Public Health Service (Grant H141-C8), and the Eli Lilly and Company, Indianapolis.

AMA Arch Intern Med. 1960;105(3):361-371. doi:10.1001/archinte.1960.00270150015003
Abstract

The purpose of this presentation is to discuss our experience in the use of an internal pacemaker for increasing cardiac rhythmicity in the presence of slow heart rates and for restoring cardiac beating during cardiac arrest.

The artificial pacemakers available at the present time for cardiac stimulation include the Zoll External Pacemaker,1-6 which has had several counterparts, and a number of internal pacemakers. With the external pacemaker, the stimulating electrodes are placed over the chest wall and deliver electric impulses with currents from 50 to 200 ma. and voltages from 20 to 100 volts.

Recently, various internal pacemakers have been developed 7-11 which have been used successfully in animals and in human subjects. In these internal pacemakers, which include transistor models, the stimulating wire is directly attached to the heart muscle. In addition, the voltage source of the external pacemaker may be reduced so that it, too, may be

References
1.
Manufactured by Atronic Products, Inc., Bala Cynwyd, Pa.
2.
The "Atronic Pacer/Monitor" has been used by others in patients with repeated Stokes-Adams seizures. In one (Furman12) the attachment was made by insertion of the electrode through the external jugular vein; in another,13 it was sewn into the myocardium of the ventricle through a small thoracotomy opening.
3.
Zoll, P. M.; Linenthal, A. J., and Norman, L. R.:  Treatment of Stokes-Adams Disease by External Electric Stimulation of the Heart ,  Circulation 9:482, 1954.Crossref
4.
Zoll, P. M.; Linenthal, A. J.; Norman, L. R.; Paul, M. H., and Gibson, W.:  External Electric Stimulation of the Heart in Cardiac Arrest; Stokes-Adams Disease, Reflex Vagal Standstill, Drug-Induced Standstill, and Expected Circulatory Arrest ,  A.M.A. Arch. Int. Med. 96:639, 1955.Crossref
5.
Zoll, P. M.; Linenthal, A. J.; Norman, L. R.; Paul, M. H., and Gibson, W.:  Use of the External Electric Pacemaker in Cardiac Arrest ,  J.A.M.A. 159:1428, 1955.Crossref
6.
Zoll, P. M.; Linenthal, A. J.; Norman, L. R.; Paul, M. H., and Gibson, W.:  The Effects of External Electric Currents on the Heart: Control of Cardiac Rhythm and Induction and Termination of Cardiac Arrhythmias ,  Circulation 14:745, 1956.Crossref
7.
Zoll, P. M.; Linenthal, A. J.; Norman, L. R.; Paul, M. H., and Gibson, W.:  Treatment of Unexpected Cardiac Arrest by External Electric Stimulation of the Heart ,  New England J. Med. 254:541, 1956.Crossref
8.
Callaghan, J. C., and Bigelow, W. G.:  An Electrical Artificial Pacemaker for Standstill of the Heart ,  Ann. Surg. 134:8, 1951.Crossref
9.
Weirich, W. L.; Gott, V. L., and Lillehei, C. W.:  Treatment of Complete Heart Block by Combined Use of Myocardial Electrode and Artificial Pacemaker ,  Surgical Forum 8:360, 1957.
10.
Weirich, W. L.; Paneth, M.; Gott, V. L., and Lillehei, C. W.:  Control of Complete Heart Block by Use of Artificial Pacemaker and Myocardial Electrode ,  Circulation Res. , to be published.
11.
Kilpatrick, D., and Bellet, S.: Cardiac Pacing/Stimulation by Very Portable Equipment, IRE National Convention Record, 1959.
12.
Starzl, T. E.; Gaertner, R. A., and Webb, R. C., Jr.:  The Effects of Repetitive Electric Cardiac Stimulation in Dogs with Normal Hearts, Complete Heart Block and Experimental Cardiac Arrest ,  Circulation 11:952, 1955.Crossref
13.
Herrod, C. E.; Lee, R. H.; Goggand, W. H.; McCombs, R. K., and Gerbode, F.:  Control of Heart Action by Repetitive Electrical Stimuli ,  Ann. Surg. 136:510, 1952.
14.
Furman, S.: Personal communication to the author.
15.
Durant, T.: Personal communication to the author.
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