Analysis of global climate model simulations and observations suggest decadal, midlatitude changes in and over the North Pacific cause decadal modulation of the El Niño-Southern Oscillation. This coupling between the two geographic regions is via atmospheric, not oceanographic, teleconnections. In essence, large scale changes in the circulation of the atmosphere over the Pacific Basin, while largest in midlatitudes, have a significant projection onto the wind field overlying the equatorial regions. These low frequency wind changes precondition the mean state of the thermocline in the equatorial ocean to produce prolonged periods of enhanced or reduced ENSO activity. The midlatitude variability that drives equatorial impacts is of stochastic origin and, although the magnitude of the signal is enhanced by ocean processes, likely unpredictable.