What causes myopotential inhibition of a pacemaker?
In addition to electrocautery, other forms of
electrical activity may also interfere with pacemaker function. Succinylcholine
causes diffuse muscle fasciculations in many patients, and these fasciculations
are only partially prevented by defasciculating doses of nondepolarizing muscle
relaxants. During muscle fasciculations, depolariz-ing membranes produce
electrical discharges, which may inhibit a pacemaker. A unipolar pacemaking
system’s positive pole (anode) is in the generator case, which is usually
located in close proximity to the pectoralis major muscle. This can result in
myopotential inhibition.
Asystole following the administration of
succinylcholine is best treated by placing a magnet over the pacemaker
gen-erator to temporarily convert the pacemaker to an asyn-chronous mode.
Alternate means of pacing include external pacemakers and temporary transvenous
pacemakers (including specially designed pulmonary artery catheters).
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