Abstract
Chest wall electrical stimuli, too weak to affect the heart, act as electrical signals to an implanted ventricular-inhibited (QRS blocking) demand pacemaker which interprets them as originating from the heart and consequently responds according to its specifications. Rapid external stimulation permits diagnostic interpretation of the spontaneous electrocardiogram by completely inactivating the implanted pacemaker. The slow random delivery of external stimuli throughout the cardiac cycle delineates the pacemaker refractory period after the emission of a pacing stimulus and after the sensing of a spontaneous beat. During apparent fixed-rate pacing the demand capability of the pacemaker may be easily seen by appropriately timed chest wall stimulation which induces the pacemaker to sense a spontaneous QRS complex. This simple technique may reveal subtle changes in pacemaker performance, and contributes to the understanding of pacemaker arrhythmias.
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- Castellanos A., Jr, Lemberg L., Jude J. R., Mobin-Uddin K., Berkovits B. V. Implantable demand pacemaker. Br Heart J. 1968 Jan;30(1):29–33. doi: 10.1136/hrt.30.1.29. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Castellanos A., Jr, Maytin O., Lemberg L., Berkovits B. V. Ventricular-- triggered pacemaker arrhythmias. Br Heart J. 1969 Sep;31(5):546–552. doi: 10.1136/hrt.31.5.546. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Chatterjee K., Harris A. M., Davies J. G., Leatham A. T-wave changes after artificial pacing. Lancet. 1969 Apr 12;1(7598):759–760. doi: 10.1016/s0140-6736(69)91758-9. [DOI] [PubMed] [Google Scholar]
- Friedberg H. D. Syncope during standby cardiac pacing. Br Heart J. 1969 May;31(3):281–284. doi: 10.1136/hrt.31.3.281. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rubin I. L., Arbeit S. R., Gross H. The electrocardiographic recognition of pacemaker function and failure. Ann Intern Med. 1969 Sep;71(3):603–615. doi: 10.7326/0003-4819-71-3-603. [DOI] [PubMed] [Google Scholar]
- Samet P., Center S., Linhart J. W., Keller W. Selected current aspects of cardiac pacing. Electrocardiographic patterns. Am J Cardiol. 1969 May;23(5):702–711. doi: 10.1016/0002-9149(69)90033-2. [DOI] [PubMed] [Google Scholar]
- Smyth N. P. Cardiac pacemaking. Ann Thorac Surg. 1969 Aug;8(2):166–190. doi: 10.1016/s0003-4975(10)66225-x. [DOI] [PubMed] [Google Scholar]
- Sowton E., Balcon R., Preston T., Leaver D., Yacoub M. Long-term control of intractable supraventricular tachycardia by ventricular pacing. Br Heart J. 1969 Nov;31(6):700–706. doi: 10.1136/hrt.31.6.700. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sowton E. Cardiac pacemakers and pacing. Mod Concepts Cardiovasc Dis. 1967 Jun;36(6):31–36. [PubMed] [Google Scholar]