Improved pacemaker pulse detection: clinical evaluation of a new high-bandwidth electrocardiographic system

This study compares the pacemaker pulse detection performance of the new high-bandwidth (hi-fi) electrocardiographic (ECG) acquisition system to a conventional system in a prospective clinical evaluation.

Electrocardiograms from 88 subjects with implanted pacemakers were recorded using different pacemaker programmed outputs and with different noise levels. Each ECG was recorded simultaneously from both systems. A cardiologist independently confirmed the clinically relevant ECGs. The pacemaker pulse detection sensitivity and positive predictive value (PPV) of each system were computed. The efficacy of each system was evaluated using a z test.

For the independently confirmed reports, the hi-fi system was superior, with higher sensitivity (99.2% vs 83.2%, P < .0001) and higher PPV (100% vs 99.9%, P = .33), for the detection of pacemaker pulses.

In a large group of subjects with implanted pacemakers and even in noisy conditions, the new hi-fi system was shown to improve pacemaker pulse detection sensitivity and PPV.