| Popis: |
To the Editor.— Along with environmental, metabolic, and pharmacologic influences on artificial cardiac pacing, important threshold changes have been reported to occur incident to changes in physical activity. 1 Clinically evident interruption of pacing as the result of these influences has largely been reported as a result of drug administration. 2,3 We have recently seen a patient in whom a pacemaker malfunction occurred only during sleep. Report of a Case.— A 74-year-old white man underwent initial implantation of an artificial pacing system in November of 1962 for a stable arteriosclerotic third-degree heart block. Since that time the patient has undergone 12 different procedures incident to the management of various complications causing pacemaker failure. These include, over the years, skin erosion with extrusion of the pulse generator, wire fracture, infection of the battery pocket, electrode dislocation, battery fatigue, and finally threshold change. He was seen in the office on Dec 23 |
