Kristensen Lene, Nielsen Jens Cosedis, Mortensen Peter Thomas, Pedersen Anders Kirstein, Andersen Henning Rud
Department of Cardiology, Skejby Hospital, Aarhus University Hospital, Brendstrupgaardsvej, 8200 Aarhus N, Denmark.
Europace. 2004 Nov;6(6):580-5. doi: 10.1016/j.eupc.2004.08.002.
The aim of the present study was to validate pacemaker telemetry as a diagnostic feature for detecting atrial tachyarrhythmias (AT) during pacemaker treatment in patients with sick sinus syndrome (SSS).
Patients with SSS and bradytachy syndrome (n = 28, 20 women), mean age 71 +/- 10.3 years, were included. The patients were treated with AAIR (n = 14) or DDDR pacing. At a routine follow-up visit pacemaker telemetry was reset and the patients underwent Holter recording for at least 24 h. Episodes of atrial fibrillation (AF) during Holter recording were compared with episodes of AT detected by the pacemaker. Only episodes of AF lasting for at least 1 min during Holter recording were registered. AT detected by the pacemaker telemetry was defined as: an atrial high rate episode with a rate of > or = 220 bpm for > or = 5 min, atrial sensing with a rate of > or = 170 bpm in > or = 5% of total counted beats, mode-switching in > or = 5% of total time recorded or a mode-switching episode of > or = 5 min. Twenty-eight Holter recordings (mean duration 31.5 h, range 20-72 h) were used for evaluation. Ten patients had one or more episodes of AF lasting at least 1 min on their Holter recordings. Nine of these patients had AT detected by their pacemaker telemetry according to our criteria. None of the patients had AT detected by the pacemaker telemetry and not by the Holter recording. The specificity and sensitivity for detection of AT recorded by the pacemaker telemetry in this study was 100% and 90%, respectively. The false-positive rate was 0%.
Pacemaker telemetry was found to be a reliable tool for detecting AT in patients with SSS.
本研究旨在验证起搏器遥测作为检测病态窦房结综合征（SSS）患者起搏器治疗期间房性快速心律失常（AT）的诊断特征。
纳入了患有SSS和慢快综合征的患者（n = 28，20名女性），平均年龄71±10.3岁。患者接受AAIR（n = 14）或DDDR起搏治疗。在常规随访时重置起搏器遥测，并让患者进行至少24小时的动态心电图记录。将动态心电图记录期间的房颤（AF）发作与起搏器检测到的AT发作进行比较。仅记录动态心电图记录期间持续至少1分钟的AF发作。起搏器遥测检测到的AT定义为：房率≥220次/分且持续≥5分钟的房性高率发作、在总计数搏动的≥5%中房率≥170次/分的心房感知、在记录的总时间的≥5%中发生模式转换或模式转换发作≥5分钟。使用28份动态心电图记录（平均时长31.5小时，范围20 - 72小时）进行评估。10名患者在其动态心电图记录中有一次或多次持续至少1分钟的AF发作。其中9名患者根据我们的标准通过起搏器遥测检测到AT。没有患者通过起搏器遥测检测到AT而动态心电图记录未检测到。本研究中起搏器遥测记录AT的特异性和敏感性分别为100%和90%。假阳性率为0%。
发现起搏器遥测是检测SSS患者AT的可靠工具。
