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Europace 2002 4(1):55-59; doi:10.1053/eupc.2001.0210
© 2002 by European Society of Cardiology
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PACING

Pacemaker troubleshooting: improved efficacy using a new diagnostic digital Holter recording system

J. P. Moak, B. Gunderson1, V. Freedenberg and C. Ramwell

Department of Cardiology, Children's National Medical Centre Washington, DC, U.S.A.; 1Medtronic Inc, Fridley Minnesota, U.S.A.

Asymptomatic dysfunction of cardiac pacing systems is not uncommonly detected using long-term ambulatory monitoring techniques. We report two patients with atrial and ventricular sensing abnormalities noted only on Holter monitoring. Multiple empirical attempts at pacemaker reprogramming based on deductive analysis of the pacing anomaly were unsuccessful. Through the use of a new digital recording system that allowed collection of surface electrocardiographic data, intracardiac electrograms, and Marker ChannelTM data a correct diagnosis was made (pacing lead insulation failure). This new recording system has the advantage of significantly improving diagnostic sensitivity and resulting in cost savings.

Key Words: Pacemaker troubleshooting, sensing abnormalities, Holter monitoring, pacing lead fracture

Correspondence: Dr Jeffrey P. Moak, Department of Cardiology, Children's National Medical Centre, Washington, DC 20010, U.S.A. E-mail: jmoak{at}CNMC.org


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