A review of General Electric (G.E.) electronic cardiac pacemakers for symptomatic complete A-V heart block in two sequential three-year periods at the University of Michigan Medical Center indicates that there has been no increase in the useful life of these units. With G.E. epicardial pacemakers failure occurred after an average of 12 months. In the early years the major cause of failure was wire breakage, and the later major cause was battery exhaustion or component failure. Exit block was a major complication. There was no improvement when G.E. catheter pacemakers were used instead of the epicardial type. The Medtronic catheter pacemakers lasted longer, with fewer battery and component failures and no instances of exit block. Although infection was more common with Medtronic pacemakers, secondary to erosion of the power unit or the catheter through the skin, it may be that this complication could be eliminated by locating the battery box beneath the latissimus dorsi muscle in the axilla and by careful catheter placement to avoid pressure necrosis and subsequent cutaneous perforation.
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