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Europace 2005 7(3):242-247; doi:10.1016/j.eupc.2005.01.005
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© 2005 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved.

Automatic analysis of pacemaker diagnostic data in the identification of atrial tachyarrhythmias in patients with no prior history of them

A. Schucherta,*, S. Lepageb, J.J. Ostranderc, R.J. Bosd, M. Gwechenbergere, A. Nichollsf and G. Ringwaldg

aHeart Center, University Hospital Hamburg-Eppendorf Hamburg, Martinistrasse 52, D-20251 Hamburg, Germany; bCentre Hospitalier Universitaire de Sherbrooke Sherbrooke, QC, Canada; cGrey Bruce Health Services Corporation Owen Sound, ON, Canada; dFranciscus Ziekenhuis Roosendaal, The Netherlands; eAKH Wien, Austria; fLeeds General Infirmary Leeds, UK; gGemeinschafts Praxis Bruchsal, Germany

AIMS: Modern pacemakers provide a large amount of diagnostic data. Given the limited time available during a pacemaker follow-up visit essential information may be overlooked. This registry was conducted to assess the utility of an expert system that analyses the diagnostic data collected by an implanted pacing device and notifies and advises the physician about suspected technical issues and arrhythmias that need further attention.

METHODS: Patients with various standard indications for pacing were included in this registry and received single or dual chamber pacemakers. Data were collected and analysed by the expert system during at least two subsequent follow-up visits. The evaluation of this system focused on data obtained from patients with a dual chamber pacing device without prior history of atrial arrhythmias.

RESULTS: A total number of 239 patients without prior history of atrial tachyarrhythmias were included in this analysis. Atrial tachyarrhythmias were detected in 73 (31%) of these patients. The highest incidence of newly detected arrhythmias occurred in the group of patients with high-degree AV block and VDD pacemakers. Furthermore, newly detected arrhythmias predominantly occurred in the period shortly after implantation. Device programming suggestions by the expert system were adopted in 30% of the cases. Following detection of atrial tachyarrhythmias by the expert system, pharmacological management was adjusted at 71% of the first follow-up visits and at 27% of later follow-up visits.

CONCLUSION: Results of this registry show that this expert system provides a valuable tool for the detection of atrial tachyarrhythmias during pacemaker follow-up visits.

Key Words: pacemaker diagnostics, expert system, atrial tachyarrhythmia

*Corresponding author. Tel.: C49 404 717 5304; fax: C49 404 717 7420. E-mail address: schuchert{at}uke.uni-hamburg.de (A. Schuchert).


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