IMO stream is the way to go. You need to run inside a transaction but that should not be a problem. You should be able to do neat things such as:

Repo.stream(...)
|> Task.async_stream(&deliver/1, max_concurrency: 10)
|> Stream.run

and that will get emails in batches of 10 and invoke the google email api concurrently. It requires Elixir v1.4.

You can increase the timeout for the transaction where streaming happens:

Repo.transaction(fn -> ... end, timeout: some_huge_number)

You need to remember that LIMIT + OFFSET pagination is prone to race conditions - it may happen that you’ll miss some rows or see rows that you shouldn’t. Database-level cursor gives a consistent view of data.

Detailed explanation there: We need tool support for keyset pagination

Short version, when iterating over the records get the max range and the min range to make sure it’s used in your where clause. This trims the result set BEFORE sorting. Using LIMIT and OFFSET means the entire possible result has to be loaded and sorted to calculate which chunk of them is coming back.