Myopotential inhibition of a bipolar pacemaker caused by electrode insulation defect.

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Abstract
A patient is described in whom myopotentials originating from the anterior abdominal wall muscles suppressed the implanted demand pacemaker despite its bipolar mode of action. This phenomenon was shown by simultaneous recording of the ECG and the electromyogram. At operation a defect in the insulation of a previously repaired epicardial electrode was found lying in close proximity to these muscles. After repair of the insulation defect normal pacemaker function was restored. The myopotentials may have leaked into the pacing system through the insulation defect, thereby suppressing the demand unit, which maintained its bipolar mode of pacing throughout.