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The spectacular advances in the surgery for congenital heart disease in children and infants have led to the appearance of a new pathology, late complications which warrant a systematic cardiological surveillance, to allow the patient to lead as normal a life as possible, compatible with the potential sequelae of this type of surgery. These complications arise essentially after ventricular open heart surgery, especially for tetralogy of Fallot and for interventricular communications. The ventricular function may be altered, even if the functional status appears to be good, so it must be systematically monitored, in particular by isotope methods.

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The authors report 25 cases of patients, average age 67 years with severe coronary or valvular heart disease, with conduction disorders. The conduction disorder occurred alone in 8 cases and was associated with a disorder of excitability in 17 cases. It was either obvious, as in 14 cases, or latent, as in 11 cases, and precipitated by various forms of treatment, the disadvantage of which was the negative dromotrope effect.

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The observations of 2 patients having carotid sinus syncopes treated by temporary (1 case), or definitive (1 case) endovenous demand cardiac pacing are correlated with 15 similar observations found in the literature. In all these patients, cardiac pacing is more effective than all the other treatments cutting off the hyperactive reflex. Indeed, carotid sinus hypersensibility seems to be good, though unusual indication of cardiac pacing.

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