City Operation To Control Heartbeat

Press, Volume CII, Issue 30302, 30 November 1963, Page 12

City Operation To Control Heartbeat

The first operation in Christchurch for the insertion of an artificial pacemaker into a patient to control the rate of heartbeat has been carried out successfully on a middle-aged woman. The operation was performed at the Christchurch Hospital by the North Canterbury Hospital Board’s thoracic surgeon.

The operating technique was introduced into New Zealand by a group at the Green Lane Hospital, Auckland, where 23 such operations have now been carried out. The woman given the operation in Christchurch was to have been treated in Auckland, but she was thought to be too ill to travel and it was decided to operate here. In future, Christchurch patients needing the operation will probably not need to travel.

The pacemaker is a transistorised electronic instrument about 2in in diameter and weighing soz. It is inserted into a pouch made by the surgeon in the patient's abdomen. The heart is then exposed, and a tunnel made through the body wall from the pouch to the heart. Two leads are brought through the tunnel from the pacemaker.

The leads terminate in electrodes which are sewn into the muscle of a ventricle of the heart

The batteries in the pacemaker should enable it to keep going for between two and five years. To guard against its failure, however, an “emergency pigtail’’ is sewn into the body wall near the pouch and may be extracted under a local anaesthetic. Impulses from an external pacemaker may then be fed in until the internal pacemaker can be permanently replaced. The condition which the operation is designed to correct is heart-block, in which there is a failure in the electrical pathway from the heartbeat-controlling node to the ventricles of the heart. If the electrical impulse to the ventricles fails, they beat at their own speed, which is much slower than the normal heartbeat rate.

Patients suffering from heart-block show typical symptoms of lack of blood, including, especially, a tendency to fainting and dizziness. The beating may stop altogether. resulting in “Stoke - Adams attacks." characterised by unconsciousness and. if the stoppage continues. death.