GIOVANNI A. PUPILLO, M.D.; JOSEPH W. LINHART, M.D.
An "extra" heart sound just before the first heart sound and probably caused by intercostal muscle contraction due to pacemaker stimulation may be present in some patients during cardiac pacing. This sound may be confused with other auscultatory phenomena, especially when its associated chest-wall movements are not apparent. In patients with QRS-blocking demand pacemakers this sound may be identified by temporarily suppressing pacemaker activity by the chest-wall stimulation technique in conjunction with phonocardiography. Elimination of pacemaker activity eliminates the "extra" sound.
PUPILLO GA, LINHART JW. Chest-Wall Stimulation and Phonocardiography in the Identification of the Pacemaker Heart Sound. Ann Intern Med. 1970;73:439–441. doi: 10.7326/0003-4819-73-3-439
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Published: Ann Intern Med. 1970;73(3):439-441.
Cardiac Diagnosis and Imaging, Cardiology, Rhythm Disorders and Devices.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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