Guglin Maya E, Datwani Neeta
Wayne State University/John D. Dingell VAMC, Department of Medicine, Section of Cardiology, Detroit, MI 48201, USA.
J Electrocardiol. 2007 Apr;40(2):144-6. doi: 10.1016/j.jelectrocard.2006.07.001. Epub 2006 Aug 21.
We analyzed the accuracy with which a computer algorithm reads electrocardiograms (ECGs) with electronic pacemakers (PMs).
Electrocardiograms were screened for the presence of electronic pacing spikes. Computer-derived interpretations were compared with cardiologists' readings.
Computer-drawn interpretations required revision by cardiologists in 61.3% of cases. In 18.4% of cases, the ECG reading algorithm failed to recognize the presence of a PM. The misinterpretation of paced beats as intrinsic beats led to multiple secondary errors, including myocardial infarctions in varying localization. The most common error in computer reading was the failure to identify an underlying rhythm. This error caused frequent misidentification of the PM type, especially when the presence of normal sinus rhythm was not recognized in a tracing with a DDD PM tracking the atrial activity.
The increasing number of pacing devices, and the resulting number of ECGs with pacing spikes, mandates the refining of ECG reading algorithms. Improvement is especially needed in the recognition of the underlying rhythm, pacing spikes, and mode of pacing.
我们分析了一种计算机算法读取带有电子起搏器（PM）的心电图（ECG）的准确性。
对心电图进行筛查，以确定是否存在电子起搏尖峰。将计算机得出的解读结果与心脏病专家的读数进行比较。
在61.3%的病例中，计算机绘制的解读结果需要心脏病专家进行修正。在18.4%的病例中，ECG读取算法未能识别出PM的存在。将起搏搏动误判为固有搏动会导致多种继发性错误，包括不同部位的心肌梗死。计算机解读中最常见的错误是未能识别基础心律。这种错误经常导致PM类型的误判，尤其是当在带有跟踪心房活动的DDD PM的心电图中未识别出正常窦性心律时。
起搏设备数量的增加以及由此产生的带有起搏尖峰的心电图数量，要求完善ECG读取算法。尤其需要在识别基础心律、起搏尖峰和起搏模式方面加以改进。
