High Myocardial Threshold to an Artificial Pacemaker — Report of a Fatal Case

Abstract

FAILURE of the myocardium to respond to an electronic pacemaker with implanted electrodes, because the threshold to electric stimulation is abnormally high, is known to occur occasionally.^{1 , 2} In all the cases reported in which this difficulty has arisen, it has been corrected by replacement with a new unit, by an increase in the energy output of the implanted unit or by appropriate drug therapy. We are not aware of any previous report of a patient with a normally functioning pacemaker who died primarily because the myocardium was no longer responding to what had previously been an adequate stimulus, and wish . . .