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Jorge M. Alegre, MD; Richard Yore, MD
St. Louis

JAMA. 1970;212(3):481.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Treatment of patients with heart block by transvenous pacemakers has become commonplace. The following case demonstrates one of the hazards of electrode insertion and clearly illustrates the cause and the correction of this complication.

Report of a Case.—

A 65-year-old woman was admitted to St. Luke's Hospital after her physician detected intermittent second-degree atrioventricular block on a routine medical examination. The patient was asymptomatic. She was in no distress. The left border of cardiac dullness was 10 cm to the left of the midsternal line. The heart rate varied from 65 to 34 beats per minute. A grade 2/6 blowing systolic murmur was heard over the entire precordium, loudest at the apex. Aortic second sound was greater than pulmonic second sound.

The electrocardiogram showed a normal sinus rhythm and right bundlebranch block, but cardiac monitoring showed intermittent second degree (2 to 1) atrioventricular block. Serum enzymes (CPK . . . [Full Text PDF of this Article]

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