[Double-chamber pacemakers. Implantation in a schoolboy for a traumatic lesion of the conduction tissue]

The technological advance of artificial cardiac stimulation in the last fifteen years has been spectacular. The increased life span of generators brought on by the use of lithium batteries, as well as the new platinum anodized leads which reduce their polarization tension, increasing current density to a maximum and thereby lowering chronic stimulation thresholds, mark a new stage in artificial cardiac stimulation. During the current decade there have been three major advances: stimulation by means of DDD-type dual chamber pacemakers; generators activated by muscle movement; and the prototypes of cardioverter-defibrillator automatic pacemakers in the experimental phase. This is the case of an eleven-year-old schoolboy who suffered a traumatic lesion of conductive tissue by an accidental gunshot wound, lead shot being lodged in the proximities of the atrial-ventricular junction, resulting in stokes-Adams due to the presence of complete AV blockage, in whom a dual chamber symbios pacemaker was implanted by endocardial way, by which means he returned to a normal life even insofar as athletic activity is concerned.