An asymptomatic 48-year-old gentleman presented for routine
interrogation of his Medtronic dual chamber transvenous pacemaker. The
device was implanted 4 years ago for post-operative intermittent high
grade atrio-ventricular block following mechanical aortic valve
replacement. As per our protocol, we performed a 12-lead
electrocardiogram with and without magnet application. The unusual
response elicited after application of magnet is mechanistically
explained.