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Related Experiment Videos

Holter recordings with continuous marker annotation to evaluate pacemaker function.

Bernd Nowak1, Sophie Henry, Roland Mols

  • 1II. Medical Clinic, University Mainz, Germany. nowak@ccb.de

Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
|February 15, 2002
PubMed
Summary

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The Telemetry Holter Decoder (THD) enables continuous pacemaker marker annotations on Holter recordings, offering superior diagnostic insights compared to ECG alone for device behavior analysis.

Area of Science:

  • Biomedical Engineering
  • Cardiology
  • Medical Device Technology

Background:

  • Pacemaker marker annotations are crucial for interpreting device function but typically require a dedicated programmer.
  • Conventional Holter monitoring lacks continuous marker annotation capabilities, limiting comprehensive device behavior analysis.
  • A prototype Telemetry Holter Decoder (THD) was developed to provide continuous marker annotations on standard Holter recordings.

Purpose of the Study:

  • To evaluate the diagnostic value of the prototype THD for continuous pacemaker marker annotation.
  • To assess the feasibility and utility of integrating THD-generated annotations with conventional Holter ECGs.
  • To determine if THD provides information beyond standard ECG interpretation for pacemaker function.

Main Methods:

Related Experiment Videos

  • Twenty patients with VDD or DDDR pacemakers underwent 24-hour Holter monitoring using the THD.
  • Pacemaker marker annotations were transmitted to the THD and converted into analog signals recorded on a Holter channel.
  • Data quality and diagnostic yield of THD annotations were analyzed against ECG findings.

Main Results:

  • High-quality marker annotations were obtained for all patients across 458 hours of recording, with minimal artifacts (0.67%).
  • THD revealed significant findings not visible on ECG, including 1096 instances of intermittent atrial undersensing and 2 cases of atrial tachycardia.
  • THD accurately annotated 11,516 tachycardia response events, identified 4294 instances of atrial far-field sensing/VA conduction, and detected 3 instances of electromagnetic interference.

Conclusions:

  • Continuous, high-quality pacemaker marker annotation on conventional Holter monitoring is feasible using the THD.
  • The THD provides critical insights into pacemaker behavior, surpassing ECG interpretation alone, even in patients with seemingly regular device function.
  • THD data facilitates improved pacemaker programming, troubleshooting, and validation of novel device algorithms.