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September 1967

Implantable Pacemakers in Heart Block: Tolerance of Elective Noncardiac Operations

Author Affiliations

St. Louis
From the Department of Surgery, St. Louis University School of Medicine, St. Louis University Surgical Service, the Veterans Administration Hospital, and the St. Louis University Surgical Service, St. Louis City Hospital.

Arch Surg. 1967;95(3):351-354. doi:10.1001/archsurg.1967.01330150027005

THERE are now a large number of patients with heart block treated by implantable pacemakers. Such individuals are subject to noncardiac conditions which demand treatment by operation. The presence of heart block as well as the generally advanced age of these patients may be viewed by some as a contraindication to operation. We have reviewed our experience in order to determine the advisability of secondary operations in patients with heart block, controlled by electrical pacing.

Material  This study is based upon 66 patients with second and third degree heart block who have undergone operation. Their ages varied from 5 to 89 years with a median of 70 years. Seventyone percent were 65 years of age or older. There were more than twice as many male patients (47:19). Heart block was thought to be caused by arteriosclerotic heart disease in 30, by fibrous replacement of the conducting system1 in 30, by

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