Document Detail

Diagnostic value of stored electrograms in pacemaker patients.
MedLine Citation:
PMID:  18372582     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Stored electrograms (EGMs) are diagnostic tools in modern pacemakers, providing data concerning arrhythmia occurrence and device function. We sought to validate the impact of stored EGMs on diagnosis and verification of arrhythmias presented after pacemaker implantation. METHODS AND RESULTS: We enrolled 71 consecutive patients (mean age 64 +/- 8 years, 51 men) with a standard indication for pacemaker implantation. The following pacemaker devices were implanted: DDDR = 57, VDDR = 5, VVIR = 9. EGM triggers were atrial tachycardia (AT), non-sustained ventricular tachycardia (NSVT) and ventricular tachycardia (VT). We retrieved and analysed 362 EGMs at 3 and 6 months after implantation. The EGMs were triggered by AT in 260 EGMs (72%), by NSVT in 80 (22%) and by VT in 22 (6%). In total, 243 episodes (67%) confirmed the arrhythmic events, while 119 episodes (33%) were classified as false-positive. They were divided into false-positive AT in 85 EGMs (33%), false-positive NSVT in 28 (35%) and false-positive VT in 6 EGMs (27%). The false-positive AT cases were caused by ventricular far-field sensing from the atrial channel in 34 EGMs (40%) and noise or myopotentials in 51 EGMs (60%). Most of the false-positive VT and NSVT episodes were due to atrial fibrillation or atrial tachycardias in 21 EGMs (62%), while the rest were caused by noise in 11 EGMs (32%) or ventricular T wave oversensing in 2 EGMs (6%). CONCLUSIONS: Stored EGMs in pacemaker patients were diagnostic in two thirds of arrhythmic episodes. They are useful tools to diagnose arrhythmias and identify sensing problems, and they contribute to optimal device programming and patient management.
Stelios Paraskevaidis; Georgios Giannakoulas; Kostas Polymeropoulos; Vasilis Vassilikos; Chrisafios Girasis; Stavros Hadjimiltiades; Georgios Parcharidis
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta cardiologica     Volume:  63     ISSN:  0001-5385     ISO Abbreviation:  Acta Cardiol     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-03-31     Completed Date:  2008-05-30     Revised Date:  2009-06-11    
Medline Journal Info:
Nlm Unique ID:  0370570     Medline TA:  Acta Cardiol     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  59-63     Citation Subset:  IM    
First Cardiology Department, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
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MeSH Terms
Arrhythmias, Cardiac / diagnosis*
Electrocardiography, Ambulatory*
Middle Aged
Pacemaker, Artificial*

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