148 research outputs found
Do Lekarza Rodzinnego przychodzi pacjent z wszczepionym rozrusznikiem.... Krótkie kompendium postępowania cz 1
Krótkie kompendium opisu EKG u pacjenta z wszczepionym rozrusznkiem
Do Lekarza Rodzinnego przychodzi pacjent z wszczepionym rozrusznikiem.... Krótkie kompendium postępowania- cz II
W drugiej części krótkiego kompendium zajmiemy się przykładami EKG prezentującymi pracę rozrusznika zaprogramowanego do pracy w trybie DDD.Jest to obecnie najczęściej stosowany tryb stymulacj
Is the diagnostic function of pacemakers a reliable source of information about ventricular arrhythmias?
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. (Cardiol J 2010; 17, 5: 495-502
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