Signal "peak" and "valley" removal properties of mathematical morphology operators are exploited in a method and apparatus for detecting, removing, or improving fidelity of pacemaker signal components of the Electrocardiogram (ECG) at sampling rates well below the pacemaker signal Nyquist rate. The method works for the wide variability in pacemaker signal amplitude, width, firing frequency, and other characteristics encountered in practice, and it works for malfunctioning pacemakers that may fire at any point relative to the QRS complex of the ECG signal. Filtering operations require minimal digital storage and are computationally inexpensive (no multiplications), mainly involving "maximum" and "minimum" type signal detections over a finite time history of the input signal. This implies that the method can be inexpensively implemented on small instruments in either hardware or software. The method may also be used to estimate the height and polarity of the pacemaker voltage spike, even though the base sampling period may be longer than the width of the spike.