Indications for Cardiac Pacing in Patients With Bradyarrhythmias: Title and subTitle BreakDo We Know All the Answers? FREE

Anil K. Bhandari, MD; Shahbudin H. Rahimtoola, MB, FRCP

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JAMA. 1984;252(10):1327-1328. doi:10.1001/jama.1984.03350100057032

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ABSTRACT

ABSTRACT | REFERENCES

The past decade has witnessed a rapid increase in the use of pacemakers. In 1981, an estimated 118,000 pacemakers were implanted in patients in the United States.¹ There is a concern that the use of pacemakers may be "excessive"; however, this theory has not been objectively documented. In the current issue of The Journal, a self-appointed committee² has outlined criteria for permanent cardiac pacing in the treatment of bradyarrhythmias. This report is timely and merits careful reading. Although most of the recommendations made by Phibbs et al² would meet with general approval, others need additional appraisal.

It should be recognized that the report does not evaluate (1) the role of cardiac pacing in the treatment of tachyarrhythmias,³ (2) the role of temporary pacing, or (3) the special problems of bradyarrhythmias in patients with an acute myocardial infarction.⁴

In many clinical situations, the indications for permanent

REFERENCES

ABSTRACT | REFERENCES

Personnet V, Crawford C, Bernstein A: The 1981 United States survey of cardiac pacing practices . J Am Coll Cardiol 1984;;3:1321-1332.

Phibbs B, Friedman HS, Graboys TB, et al: Indications for pacing in the treatment of bradyarrhythmias: Report of an independent study group . JAMA 1984;;252:1307-1311.

Ohm OJ, Michelson EL, Dreifus LS: Role of pacing in the treatment of tachycardias , in Surawicz B, Reddy CP, Prystowsky E (eds): Tachycardias . Boston, Martinus Nijhoff Publishing, 1984;, pp 513-533.

DeGuzman M, Rahimtoola SH: What is the role of pacemakers in patients with coronary artery disease and conduction abnormalities? in Rahimtoola SH (ed): Controversies in Coronary Artery Disease . Philadelphia, FA Davis Co, 1983;, pp 191-208.

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McAnulty JH, Rahimtoola SH: Bundle branch block . Prog Cardiovasc Dis 1984;;26:333-351.

Dhingra RC, Wyndham C, Bauernfeind R, et al: Significance of block distal to the His bundle induced by atrial pacing in patients with chronic bifascicular block . Circulation 1979;;60:1455-1464.

Ezri M, Lerman BB, Marchlinski FE, et al: Electrophysiologic evaluation of syncope in patients with bifascicular block . Am Heart J 1983;;106:693-697.

Conde C, Leppo J, Lipski J, et al: Effectiveness of pacemaker treatment in the bradycardia tachycardia syndrome . Am J Cardiol 1973;;32:209-214.

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Rosen KM, Loeb H, Gunnar R, et al: Mobitz type II block without bundle branch block . Circulation 1971;;44:1111-1119.

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