Key result
Abnormal prolongation in the pacing interval of external demand pacemakers was caused by unrecorded signals from a partial lead fracture in one case and a faulty pacemaker unit in the other.
Case Report (n=2)
Simple bedside recordings can effectively localize the cause of external demand pacemaker inhibition due to abnormal sensing not visible on conventional surface ECGs.
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Bedside recordings may localize hidden causes of external pacemaker inhibition; hypothesis-generating in Level 5 evidence.
Two cases with external demand pacemakers are presented because of abnormal prolongation in the pacing interval. In both cases, pacemaker inhibition was caused by signals which were not recorded by the conventional surface electrocardiograms. In one case, inhibition was related to a partial lead fracture which generated a voltage transient in the region of the T wave. In the other case, inhibition was caused by current emitted from a faulty pacemaker unit. In both cases precise localization of the problem was possible by simple bedside recordings and measurements.
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Waxman et al. (1974) conducted a case report in Demand pacemaker malfunction (n=2). External demand pacemakers was evaluated on Pacemaker inhibition caused by unrecorded signals. Abnormal prolongation in the pacing interval of external demand pacemakers was caused by unrecorded signals from a partial lead fracture in one case and a faulty pacemaker unit in the other.
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