Malik M, Camm A J
Department of Cardiological Sciences, St. George's Hospital Medical School, London, United Kingdom.
Pacing Clin Electrophysiol. 1988 Nov;11(11 Pt 2):2093-100. doi: 10.1111/j.1540-8159.1988.tb06356.x.
The explanation and interpretation of ECGs recorded from paced patients may be very difficult because of pacemaker specification, programmed parameters, and idiosyncrasy and also because of hidden interactions between the device and its environment. Moreover, the recent development of very sophisticated pacemakers makes the heart-pacemaker interaction (HPI) difficult to understand even when the recorded ECG is accompanied by an event marker. A computer system providing an automatic analysis of the HPI based on ECG data has been developed and implemented on an IBM PC AT computer. The system evaluates all possible combinations of HPI events and establishes whether they correspond to the pacemaker. The system inputs interactively the description of the pacemaker mode and programming, and the description of the analyzed ECG in the form of timing of "definite" and "possible" sensing events and generator pulses. The computer performs the analysis and establishes whether the device operates correctly within its permitted error. The system has been tested by evaluating different examples of paced ECGs. The presented examples confirm the ability of the system and show the potential for its future clinical use. Future development of the system and the provision of computer support for the understanding of the HPI of complex DDDR pacemakers are discussed.
由于起搏器规格、程控参数、个体特性，以及设备与其所处环境之间存在隐藏的相互作用，对起搏患者记录的心电图进行解释和解读可能非常困难。此外，即使记录的心电图伴有事件标记，最新的复杂起搏器的发展也使得心脏 - 起搏器相互作用（HPI）难以理解。已开发出一种基于心电图数据对HPI进行自动分析的计算机系统，并在IBM PC AT计算机上实现。该系统评估HPI事件的所有可能组合，并确定它们是否与起搏器相对应。该系统以“确定”和“可能”感知事件及发生器脉冲的时间形式，交互式输入起搏器模式和程控的描述以及被分析心电图的描述。计算机进行分析，并确定设备在允许的误差范围内是否正确运行。该系统已通过评估不同的起搏心电图示例进行了测试。给出的示例证实了该系统的能力，并展示了其未来临床应用的潜力。讨论了该系统的未来发展以及为理解复杂DDDR起搏器的HPI提供计算机支持的问题。
