RT Journal
A1 Martin DC, Jr.
T1 PAcemaker in cardiac vein
JF JAMA
JO JAMA
YR 1969
FD March 24
VO 207
IS 12
SP 2284
OP 2284
DO 10.1001/jama.1969.03150250114026
UL http://dx.doi.org/10.1001/jama.1969.03150250114026
AB To the Editor:— 
    The report by Mullen et al of two cases of cardiac tamponade from ventricular perforation by a transvenous pacemaker (203:142, 1968) brought to mind a bizarre complication from this procedure which occurred last year at the Meadowbrook Hospital, East Meadow, NY.The patient was a 75-year-old man with chronic congestive heart failure and parkinsonism who entered the hospital with complete heart block. Preliminary management with an external pacemaker was followed one month later by subcutaneous implantation of a fixed rate pacemaker, the endocardial electrode in both instances being inserted via the right external jugular vein. Complete ventricular capture was recorded, and the rate remained at 78 to 80 beats per minute. However, increasing confusion and drowsiness were noted along with a mild, persistent azotemia. A gradual deterioration ensued, and the patient died after two months in the hospital.Autopsy showed advanced arteriosclerotic heart disease, acute bronchopneumonia