Firor W B, Goldman B S
Can Med Assoc J. 1967 Jan 21;96(3):144-7.
Thirty-three patients with heart block were treated by implantation of a permanent transvenous pacemaker. There were no deaths and few complications even though 25 of these patients were over 70 years of age. Follow-up examinations, including electrocardiograms, were done in all patients.The technique of the operation is discussed and the importance of performing it under fluoroscopic guidance in a proper surgical operating suite is emphasized. This arrangement may require the use of a portable image intensifier.This simple, effective procedure can be performed under local anesthesia and with safety, even in the elderly, frail or debilitated patient. Currently it is the authors' method of choice in the treatment of heart block; thoracotomy is now obsolete unless a synchronous pacemaker is needed or a permanent transvenous pacer cannot be inserted.
33例心脏传导阻滞患者接受了永久性经静脉起搏器植入治疗。尽管其中25例患者年龄超过70岁，但无一例死亡，并发症也很少。所有患者均进行了包括心电图在内的随访检查。文中讨论了手术技术，并强调了在合适的外科手术室中在荧光透视引导下进行该手术的重要性。这种安排可能需要使用便携式影像增强器。这种简单、有效的手术可以在局部麻醉下安全进行，即使是老年、体弱或虚弱的患者也适用。目前，这是作者治疗心脏传导阻滞的首选方法；除非需要同步起搏器或无法插入永久性经静脉起搏器，否则开胸手术现已过时。
