Ventricular Fibrillation and Competitive Pacing

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Abstract
SUDDEN death in persons with artificial pacemakers is a continuing and disturbing problem. Causes include pacemaker-catheter displacement, electric-component failure, broken wires and rising pacing threshold. Each of these may be resolved in a relatively simple fashion once recognized.1 , 2 More of an unsolved problem is that of competitive rhythm between pacemaker-induced impulses and the patient's own intrinsic focus or foci. Sowton,3 comparing mortality rates between patients with competitive and noncompetitive rhythms, found the rate five times higher in the former. Individual case reports4 , 5 have documented the onset of ventricular fibrillation or tachycardia, or both, at the moment of inscription of the . . .