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October 1961

Surgical Heart Block: Influence of Electrical Pacing, Cardiotonic Drugs, and Body Temperature

Author Affiliations

From the Department of Surgery, St. Louis University School of Medicine.

Arch Surg. 1961;83(4):496-501. doi:10.1001/archsurg.1961.01300160008002

Complete atrioventricular dissociation caused by injury to the bundle of His is a serious complication of intracardiac operations. This conduction defect restricts the ability of the heart to increase cardiac output by means of increased ventricular rate. Such restriction may be relieved by drugs or electrical stimulation.1,3,5,8,10-12

This investigation was designed to appraise the effects of electrical stimulation, variations in temperature, isoproterenol, and digitalis in dogs with complete heart block.

Methods  In 20 mongrel dogs, complete heart block was induced by ligation of the bundle of His during a brief period of inflow occlusion under light thiopental sodium anesthesia.3,6 Fifteen animals were studied at the time of this procedure. Five were allowed to recover and reanesthetized for study 2 days later. Measurements were made of mean systemic arterial pressure, cardiac rate, mean left atrial pressure, and cardiac output by a dye-dilution technique.4 Left atrial pressure was regulated