Current Indications of Pacemaker Therapy

  • Guy Fontaine
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 3)


The indications of pacemaker therapy have greatly increased as a result of the findings in longitudial studies of large series of patients (1,2) showing not only that the Stokes-Adams syncope and the associated risk of sudden death may be prevented on a long-term basis, but also that the quality of life of the patients may be improved by sparing them the unpleasant symptoms caused by bradycardia (3). This has been allied with technical innovations which have increased the reliability of both the power units and their leads. The implantation of permanent pacemakers has become a well-regulated and almost always successful procedure in trained hands. When problems do arise (lead dislodgement, infection) simple remedies applied in time are nearly always effective.


Sinus Node Atrioventricular Block Right Bundle Branch Block Complete Atrioventricular Block Permanent Pace 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Edhag O:Long-term follow-up of patients with implanted pacemakers. In:Cardiac pacing, Watanabe Y (ed), Amsterdam, Excerpta Medica, 1977, p 237.Google Scholar
  2. 2.
    Torresani J, Jouve J:Cardiac pacing for more than ten years. In:Cardiac pacing, Watanabe Y (ed), Amsterdam Excerpta Medica, 1977, p 245.Google Scholar
  3. 3.
    Johansson BW:Natural history of atrioventricular block. In:Cardiac pacing, Watanabe Y (ed), Amsterdam, Excerpta Medica, 1977.Google Scholar
  4. 4.
    Lenegre J:Etiology and pathology of bilateral bundle branch block in relation to complete heart block.Prog Cardiovasc Dis 6:409, 1964.PubMedCrossRefGoogle Scholar
  5. 5.
    Kulbertus HE:The magnitude of risk of developing complete heart block in patients with LAD RBBB.Am Heart J 86:278, 1973.PubMedCrossRefGoogle Scholar
  6. 6.
    Scherlag BJ, Lau SH, Helfant RH, Berkowitz WP, Stein E, Damato AN:Catheter technique for recording His bundle activity in man.Circulation 39:13, 1969.PubMedGoogle Scholar
  7. 7.
    Lipski J, Cohen L, Espinoza J, Motro M, Dack S, Donoso E:Value of holter monitoring in assessing cardiac arrhythmias in symptomatic patients.Am J Cardiol 37:102, 1976.PubMedCrossRefGoogle Scholar
  8. 8.
    Slama R, Motte G, Grolleau R:Les Blocs atrioventriculaires paroxystiques:indications de l’exploration electrophysiologique et de l’implantation d’un stimulateur cardiaque chez un malade en rythme sinusal. In:Les Troubles du rythme cardiaque, Puech P, Slama R (eds), Nanterre, Corbiere, 1978.Google Scholar
  9. 9.
    Krikler DM, Curry PVL:Torsade de pointes, an atypical ventricular tachycardia.Brit Heart J 38:117, 1976.PubMedCrossRefGoogle Scholar
  10. 10.
    Touboul P, Ibrahim H:Atrioventricular conduction defects in patients presenting with sy cope and normal P-R interval.Brit Heart J 34:1005, 1972.PubMedCrossRefGoogle Scholar
  11. 11.
    Narula OS:Validation of his bundle recordings:limitations of the catheter technique. In:His bundle electrocardiography and clinical electrophysiology, Narula OS (ed), Philadelphia, Davis, 1975. p 65.Google Scholar
  12. 12.
    Brodsky M, Wu D, Denes P, Kanakis C, Rosen KM:Arrhythmias documented by 24 hours continuous electrocardiographic monitoring in 50 male medical students without apparent heart disease.Am J Cardiol 39:390, 1977.PubMedCrossRefGoogle Scholar
  13. 13.
    Haft JI, Weinstock M, Deguia R, et al.:Assessment of atrioventricular conduction in left and right bundle branch block using His bundle electrograms and atrial pacing.Am J Cardiol 27:474, 1971.PubMedCrossRefGoogle Scholar
  14. 14.
    Gupta PK, Lichstein E, Chadda KD:Intraventricular conduction time (H-V interval) during aterograde conduction in patients with heart blockAm J Cardiol 32:27, 1973.PubMedCrossRefGoogle Scholar
  15. 15.
    Zakaudin V, Mason DT, Fletcher RD, Awan NA, Massumi RA:Prolonged His-Q interval in chronic bifascicular block:relation to impending complete heart block.Circulation 53 (1):46–55, 1976.Google Scholar
  16. 16.
    Puech P, Grolleau R, Guimond C:Incidence of different types of A-V block and their locali-sation by His bundle recordings. In:The conduction system of the heart, Wellens HJJ, Janse MJ, Lie KI (eds), Leiden Stenfert Kroese, 1976, p 467.Google Scholar
  17. 17.
    Narula OS, Gann D, Samet P:Prognostic value of H-V intervals. In:His bundle electrocardiography and clinical electrophysiology, Narula OS (ed), Philadelphia, Davis, 1975, p 437.Google Scholar
  18. 18.
    Gupta PK, Lichstein E, Chadda KD:Follow-up studies in patients with right bundle branch block and left anterior hemiblock:significance of H-V interval.J Electrocardiol 10:221, 1977.PubMedCrossRefGoogle Scholar
  19. 19.
    Scheinman MM, Peters RW, Modin G, Brennan M, Mies C, O’Young J:Prognostic value of infranodal conduction time in patients with chronic bundle branch block.Circulation 56:240, 1977.PubMedGoogle Scholar
  20. 20.
    Altschuler H, Fisher JD, Furman S:Significance of isolated H-V interval prolongation in symptomatic patients without documented heart block.Am Heart J 97:19, 1979.PubMedCrossRefGoogle Scholar
  21. 21.
    Dhingra RC, Denes P, Wu D, Chuquimia R, Amat-Y-Leon F, Wyndham C, Rosen KM:Chronic right bundle branch block and left posterior hemi-block:clinical, electrophysiologic and prognostic studies.Am J Cardiol 36:867, 1975.PubMedCrossRefGoogle Scholar
  22. 22.
    Denes P, Dhingra RC, Wu D, Chuquimia R, Amat-y-Leon F, Wyndham CR, Rosen KM:H-V interval in patients with bifascicular block (right bundle branch block and left anterior hemi-block):Clinical, electrocardiographic and electrophysiologic correlations.Am J Cardiol 53:600, 1976.Google Scholar
  23. 23.
    Dhingra RC, Denes P, Wu D, Wyndham CR, Amat-y-Leon R, Iowne WD, Rosen KM:Prospective observations in patients with chronic bundle branch block and marked H-V prolongation.Circulation 53:600, 1976.PubMedGoogle Scholar
  24. 24.
    Seipel L, Breithardt G, Kuhn M:Significance of His bundle in bundle branch block. In:To pace or not to pace, Thalen HJTh, Harthorne JW (eds), The Hague, Martinus Nijhoff, 1978, p 33.Google Scholar
  25. 25.
    Fisher JD, Kulbertus HE, Narula OS:The prognostic value of the H-V interval PACE 1:132,Google Scholar
  26. 1978.
    Narula OS: Intraventricular conduction defects. In: His Bundle electrocardiography and clinical Electrophysiology, Narula OS (ed), Philadelphia, Davis, 1975, p 177.Google Scholar
  27. 26.
    Narula OS:Intraventricular conduction defects. In:His bundle electrocardiography and clinical Electrophysiology, Narula OS (ed), Philadelphia, Davis, 1975, p 177.Google Scholar
  28. 27.
    Narula OS:Evaluation of the cardiac conduction system by His bundle recordings. In:To pace or not to pace, Thalen HJTh, Harthorne JW (eds), The Hague, Martinus Nijhoff, 1978, p 16.Google Scholar
  29. 28.
    Wu D, Denes P, Dhingra RC, Amat-y-Leon F, Wyndham CR, Chuquimia R, Rosen KM:Electrophysiological and clinical observations in patients with alternating bundle branch block.Circulation 53:586, 1976.Google Scholar
  30. 29.
    Wong BYS, Dunn M:Transient unifascicular-bifascicular block:electrophysiologic correlation in a patient with rate-dependant left bundle branch block and transient right bundle branch block.Am J Cardiol 39:116, 1977.PubMedCrossRefGoogle Scholar
  31. 30.
    Guérot C, Coste A, Valere PE, Tricot R:L’Épreuve à l’Ajmaline dans le diagnostic des blocs auriculo-ventriculaires paroxystiques.Arch Mai Coeur 66:1241, 1973.Google Scholar
  32. 31.
    Motte G, Fournial C, Bodereau P, Kevorkian M, Welti JJ:Intérêt pronostic de l’intervalle H-V spontane et après ajmaline chez les patients ayant un bloc de branche. In:Troubles du rythme et electrostimulation:symposium, Toulouse, 1977.Google Scholar
  33. 32.
    Berkovitz WD, Wit AL, Lau SH, Sterner C, Damato AN:the effects of propranolol on cardiac conduction.Circulation 40:885, 1969.Google Scholar
  34. 33.
    Gupta PK, Lichstein E, Chadda KD:Lidocaine-induced heart block in patients with bundle branch block.Am J Cardiol 33:487, 1974.PubMedCrossRefGoogle Scholar
  35. 34.
    Pirzada FA, Venkataraman K, Madias JE, Hood WB:Prophylactic preoperative pacing. In:Topace or not to pace, Thalen HJTh, Harthorne JW (eds), The Hague, Martinus Nijhoff, 1978, p 82.Google Scholar
  36. 35.
    Falkoff M, Stowe S, Ong LS, Heinle RA, Barold S:Unusual complication of bifascicular block during surgery under general anesthesia. PACE 1:260, 1978.Google Scholar
  37. 36.
    Kimibiris D, Dreifus LS, Linhart JW:Complete heart block occurring during cardiac catheterization in patient with preexisting bundle branch block.Chest 65:95, 1974.CrossRefGoogle Scholar
  38. 37.
    Levites R, Toor M, Haft JI:Progressive improvement of His-Purkinje conduction during recovery from catheter-induced heart block.Am Heart J 91:79, 1976.PubMedCrossRefGoogle Scholar
  39. 38.
    Jacobson LB, Scheinman M:Catheter-induced intra-Hisian and intra-fascicular block during recording of His bundle electrogram.Circulation 49:579, 1974.PubMedGoogle Scholar
  40. 39.
    Sung RJ, lamer DM, Garcia OL, Castellanos Jr A, Myerburg RJ, Gelband H; Analysis of surgically-induced right bundle branch block pattern using intracardiac recording techniquesCirculation 54 (3):442–446, 1976.PubMedGoogle Scholar
  41. 40.
    Ritter WS, Atkins JM, Blomqvist CG, Mullins CB:Permanent pacing in patients with transient trifascicular block during acute myocardial infarction.Am J Cardiol 53:205 1976.CrossRefGoogle Scholar
  42. 41.
    Lister JE, Gosselin AJ, Swaye PS:Obscure syncope and the sick sinus syndrome. PACE 1:68, 1978.Google Scholar
  43. 42.
    Jordan JL, Yamaguchi I, Mandel WJ:Function and dysfunction of the sinus node:clinical studies in the evaluation of sinus node function. In:The sinus node:structure, function and clinical relevance. Bonke FIM (ed), The Hague, Martinus Nijhoff, 1978, p 2.Google Scholar
  44. 43.
    Luderitz B, Steinbeck G, Naumann C, Rosenberger W:Relevance of diagnostic atrial stimulation for treatment in Sinoatrial disease. In:The sinus node:structure, function and clinical relevance. Bonke FIM (ed), The Hague, Martinus Nijhoff, 1978, p 77.Google Scholar
  45. 44.
    Short DS:The syndrome of alternate tachycardia and bradycardia.Brit Heart J 16:208, 1954.PubMedCrossRefGoogle Scholar
  46. 45.
    Dreifus LS, Berkovits BV, Kimibiris D, Moghadam K, Haupt G, Walinsky P, Thomas P, Brockman SK:Use of atrial and bifocal cardiac pacemakers for treating resistant dysrhythmias.Eur J Cardiol 3:257, 1975.PubMedGoogle Scholar
  47. 46.
    Ryan GF, Easley RM, Zaroff LI:Paradoxical use of a demand pacemaker in the treatment of supraventricular tachycardia due to the WPW syndrome:observation of termination of reciprocal rhythm.Circulation 38:1037, 1968.PubMedGoogle Scholar
  48. 47.
    Barold SS:Therapeutic uses of cardiac pacing in tachyarrhythmias. In:His bundle electrocardiography and clinical electrophysiology, Narula OS (ed), Philadelphia, Davis 1975, p 407.Google Scholar
  49. 48.
    Fontaine G, Frank R, Coutte R, Vachon JM, Laughlin LL, Grosgogeat Y:A new technique of radio-frequency pacing to interrupt the attacks of reciprocating tachycardia in the WPW syndrome. In:Cardiac pacing, Thalen HJTh (ed), Assen, Van Gorcum, 1973, p 389.Google Scholar

Copyright information

© Martinus Nijhoff Publishers bv, The Hague 1979

Authors and Affiliations

  • Guy Fontaine

There are no affiliations available

Personalised recommendations