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Improving Diagnostic Yield for Analyzing Periodic Electrograms in the Remote Detection of Pacemaker Lead Issues
Clement Quinonero1,2,3, Marc Strik1,2, Pierre Antoine Catalan3
1CRCTB (Centre de Recherche Cardio-Thoracique de Bordeaux), INSERM (Institut National de la Santé et de la Recherche Médicale), University Bordeaux, U 1045, IHU Liryc, 33000 Bordeaux, France.
Sensors (Basel, Switzerland)
|February 13, 2025
Summary
Active electrograms (EGMs) in pacemaker monitoring detect more anomalies than passive EGMs. However, longer passive EGMs may offer similar diagnostic benefits, potentially reducing workload.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Device Technology
Background:
- Remote pacemaker monitoring reduces complications and healthcare costs.
- Passive electrograms (EGMs) offer diagnostic insights but may increase workload.
- Active EGMs temporarily adjust pacemaker settings for enhanced anomaly detection.
Purpose of the Study:
- To evaluate the added diagnostic benefit of active periodic EGMs versus passive EGMs for pacemaker anomalies.
- To assess anomaly detection rates in a large, multicenter patient cohort.
Main Methods:
- Retrospective analysis of 7068 electrograms (EGMs) from 2733 patients.
- Comparison of anomaly detection rates between passive and active EGM transmission modes.
- Inclusion of pacemakers capable of transmitting both passive and active periodic EGMs.
Main Results:
- Active modes detected significantly more anomalies (6.7%) compared to passive EGMs alone (3.3%).
- The increased detection rate was primarily attributed to the longer duration of active EGMs (36s vs. 12s).
- Atrial leads showed a particular benefit from active EGM modes.
Conclusions:
- Active EGMs demonstrate a higher diagnostic yield for pacemaker anomalies.
- Extending the duration of passive EGMs may be a more efficient strategy for enhancing diagnostic yield.
- Focusing on longer passive EGMs could reduce the need for active pacing adjustments and associated workload.
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