Document Detail


Is the diagnostic function of pacemakers a reliable source of information about ventricular arrhythmias?
MedLine Citation:
PMID:  20865681     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of this study was to evaluate the reliability of pacemaker diagnostic function in diagnosing ventricular arrhythmias.
METHODS: We compared the occurrence of ventricular ectopic beats in 51 simultaneous 24-hour electrocardiogram (ECG) recordings and pacemaker event counters printouts. The diagnostic function of a pacemaker allowed also for a qualitative assessment in 38 patients. In these cases, the occurrence of complex forms of ventricular arrhythmias was cross-checked for accelerated ventricular rhythms together with ventricular tachycardia, and triplets and couplets. The detection of at least one type of complex ventricular form of arrhythmia, diagnosed by both methods, was considered as an agreement between the methods.
RESULTS: The results of ventricular ectopic beat counts differed significantly between the methods. In three (6%) patients, the results were consistent; in 20 (39%) the pacemaker underestimated results; in 28 (55%) they were overestimated. When more liberal criteria of agreement were applied, clinically significant differences were observed in 24 (47%) patients; in seven (29%) patients the count made by the pacemaker was lowered; and in 17 (71%) it was overestimated. Ventricular tachycardias were recorded in 24-hour ECG in eight patients. In three, they were identified by the pacemaker diagnostic function. In five, the pacemaker did not recognize tachycardia (because of its frequency being below 120/min). In nine, tachycardia was recognized falsely. The sensitivity in ventricular tachycardia diagnosis by pacemaker diagnostic function was 38%, specificity - 70%, the value of a positive result - 25%, negative - 81%.
CONCLUSIONS: The evaluation of ventricular arrhythmias by pacemaker cannot serve as the only reliable diagnostic method of arrhythmias. The presence of a large number of sequences that may correspond to ventricular arrhythmia or failure to sense, should result in verification via 24-hour ECG monitoring.
Authors:
Magdalena Kumor; Rafał Baranowski; Edward Koźluk; Franciszek Walczak
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Validation Studies    
Journal Detail:
Title:  Cardiology journal     Volume:  17     ISSN:  1897-5593     ISO Abbreviation:  Cardiol J     Publication Date:  2010  
Date Detail:
Created Date:  2010-09-24     Completed Date:  2011-01-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101392712     Medline TA:  Cardiol J     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  495-502     Citation Subset:  IM    
Affiliation:
Department of Congenital Cardiac Defects, Institute of Cardiology, Warsaw, Poland. magdakumor@wp.pl
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MeSH Terms
Descriptor/Qualifier:
Aged
Electrocardiography, Ambulatory*
Equipment Failure Analysis
Female
Humans
Male
Middle Aged
Pacemaker, Artificial / adverse effects*,  standards*
Reproducibility of Results
Sensitivity and Specificity
Tachycardia, Ventricular / diagnosis*,  therapy
Ventricular Premature Complexes / diagnosis*,  therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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