Use of chest wall stimulation to localize and treat pacemaker sensing failure

A case of pacemaker malfunction in a permanently implanted demand transvenous pacemaker is presented. Complete "failure to sense," resulting in considerable hemodynamic embarrassment, was treated by chest wall stimulation using an external pacemaker and two superficial chest leads applied over the permanent pacemaker generator-lead junction. The technique of this procedure and its usefulness in the localization and temporary therapy of pacemaker sensing failure are discussed.