Thank you for your very gracious note of March 14th. I was pleased to learn of your good experience with our pacemaker.
Two papers have been prepared and are to be published. As soon as reprints of these articles are available, I will be happy
to send them to you.
In the last 18 cases in which we have implanted a cardiac pacemaker, we had a cardiac catheter electrode in position throughout
the operative procedure. We have found it comforting to have the patient driven continuously with any suitable external pacemaker
though this electrode catheter. When we have done this, we have not had any difficulty with the placement of the implantable
pacemaker. As soon as the electrodes of the implantable pacemaker are in position, the anesthetist turns off the external
pacemaker or detaches it from the end of the catheter electrode. The catheter electrode can then be easily removed, usually
in the Recovery Room.
We have purchased our electrode catheters directly from
United States Catheter and Instrument Corp.
334 Bay Street
Glen Falls, New York.
We have been using Sizes 5 and 6 and have found them entirely satisfactory. Our usual maneuver is to pass the catheter through
the left saphenous vein into the right ventricle.
The tip of the catheter must lie against the endocardium of the right ventricle, either in its apex or near the outflow tract.
If the tip of the catheter passes either into the pulmonary artery or into the right auricle, it will not pace the heart.
As long as the tip is in contact with the endocardium of the right ventricle, the patient can be paced with very low voltages.
As far as the availability of the implantable pacemakers from GE is concerned, I understand that there is still some difficulty
with this. I am expecting the delivery of several pacemakers by the end of this week. If you require one very quickly, I will
be happy to send one of mine out to you and then you can replace it when one that you order arrives.
If there is any way that I can be of further help to you, please don't hesitate to write me.