A Most Unusual Pacemaker

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We present a case of pacemaker artifact on 12-lead electrocardiogram that was initially interpreted as malfunction of the patient's dual-chamber cardiac pacemaker. It was ultimately determined to arise from an extracardiac gastric pacemaker, which had been inserted for refractory, severe diabetic gastroparesis. Proper functioning of both devices was confirmed, and settings were adjusted to test for interdevice interference. This is a report of a patient with both cardiac pacemaker and a gastric pacemaker. We review the literature on patients with multiple pacemaker devices, and conclude with several practical considerations for their care. (PACE 2011; 1–3)

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