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Malfunction of a demand pacemaker caused by phrenic nerve stimulation.

Normal function of demand pacemakers may be interfered with in the presence of electromagnetic radiation. The pulses emitted by a phrenic nerve stimulator were found to interfere with the demand function of implanted ventricular-inhibited pacemakers in 14 of 27 patients tested; however, in only five was interference observed when the transmitter was more than 5 cm away from the pacemaker. Therefore, normal function of the demand pacemaker can be preserved in patients requiring both a phrenic nerve stimulator and a cardiac pacemaker with proper selection of the site for implantation.