Treatment of Congenital and Acquired Heart Block with an Implantable Pacemaker

Abstract

The Chardack-Greatbatch implantable pacemaker has proved a worthwhile device for the management of both congenital and acquired heart block. The procedure used for implantation in 38 patients is described. The most frequent indication for use of the pacemaker is syncope due to heart block. Progressive cardiac enlargement was also an indication for pacemaker implantation in two of four children with congenital heart block. The pacemaker has also been useful in the management of surgically induced heart block and coexisting heart block that accompanies intracardiac lesions, such as aortic stenosis, which require open-heart surgery. Pacemaker failure due to electrode breakage occurred in two patients. In both instances, a replacement unit was successfully used. Three of the 38 patients have subsequently died from causes unrelated to pacemaking while one death resulted from pacemaker failure 12 months after implantation. The remaining 34 patients have remained free from cardiac symptoms during observation periods of 2 to 24 months.