Demand pacemaker arrhythmias caused by intermittent incomplete electrode fracture. Diagnosis with testing magnet

This report describes how the testing magnet was used to diagnose intermittent and incomplete electrode fracture in two patients with an implanted demand pacemaker. During fixed-rate pacing the interval between two consecutive pacemaker spikes intermittently doubled in length, suggesting that the pulse generator was continuing to fire on time into a transiently disrupted circuit. Attenuated pacemaker spikes occurring at the anticipated time of pacemaker discharge also provided a diagnostic clue. Ventricular electrograms from the defective electrodes registered small false signals.