Barold S S, Pupillo G A, Gaidula J J, Linhart J W
Br Heart J. 1970 Nov;32(6):783-9. doi: 10.1136/hrt.32.6.783.
Chest wall electrical stimuli, too weak to affect the heart, act as electrical signals to an implanted ventricular-inhibited (QRS blocking) demand pacemaker which interprets them as originating from the heart and consequently responds according to its specifications. Rapid external stimulation permits diagnostic interpretation of the spontaneous electrocardiogram by completely inactivating the implanted pacemaker. The slow random delivery of external stimuli throughout the cardiac cycle delineates the pacemaker refractory period after the emission of a pacing stimulus and after the sensing of a spontaneous beat. During apparent fixed-rate pacing the demand capability of the pacemaker may be easily seen by appropriately timed chest wall stimulation which induces the pacemaker to sense a spontaneous QRS complex. This simple technique may reveal subtle changes in pacemaker performance, and contributes to the understanding of pacemaker arrhythmias.
胸壁电刺激强度较弱，不足以影响心脏，但其作为电信号作用于植入的心室抑制型（QRS波阻滞）按需起搏器，该起搏器将其解读为源自心脏的信号，并因此根据其规格做出反应。快速的外部刺激可通过完全抑制植入的起搏器来对自发心电图进行诊断性解读。在整个心动周期中缓慢随机地施加外部刺激，可描绘出起搏刺激发出后以及感知到自发搏动后起搏器的不应期。在明显的固定频率起搏期间，通过适时的胸壁刺激可轻易观察到起搏器的按需功能，这种刺激会促使起搏器感知到自发的QRS波群。这项简单技术可能揭示起搏器性能的细微变化，有助于理解起搏器心律失常。
