The Thera pacemaker diagnostic algorithm demonstrated highly reliable detection of atrial tachyarrhythmias, achieving 98% sensitivity and 100% specificity when programmed with optimized settings.
Observational (n=45)
Does the Thera pacemaker atrial high rate episode diagnostic feature reliably detect paroxysmal episodes of atrial tachyarrhythmias compared to Holter monitoring?
The Thera pacemaker's high rate episode monitor is a reliable tool for detecting atrial tachyarrhythmias when programmed with optimized settings (detection rate 220 beats/min, detection beats 10, termination beats 20).
The atrial high rate episode diagnostic in the Thera pacemaker reports frequency, duration, and date/time of atrial tachyarrhythmias according to programmed criteria. The aim of the study was to validate the atrial high rate episode diagnostic feature. Episodes of atrial fibrillation recorded by Holter monitoring were compared to episodes detected by the pacemaker. Forty five ambulatory (Holter) recordings were used for evaluation. Thirty of 45 ambulatory (Holter) recordings showed sinus rhythm. On 4 of these 30 ambulatory (Holter) recordings, the Thera detected 12 episodes of atrial tachyarrhythmias as false-positives (sinus rhythm was detected as atrial tachyarrhythmia). The main reason was far-field R and T was oversensing. On 15 of 45 ambulatory (Holter) recordings, 125 episodes of atrial tachyarrhythmias were recorded. Ninety-three of these events also were detected by the pacemaker, while for 32 events the Thera reported sinus rhythm. The main reason was that the episodes were of too short duration. Therefore, the Thera (programmed with detection rate 160 beats/min, detection beats 40, termination beats 10) was unable to detect atrial tachycardias. Software simulation of the diagnostic algorithm under several programming settings using the digitized Holter files demonstrated highly reliable detection of atrial tachyarrhythmias (sensitivity 98%, specificity 100%) when programmed as follows: detection rate 220 beats/min, detection beats 10, termination beats 20. It can be concluded that Thera's high rate episode monitor is a reliable tool for detection of atrial tachyarrhythmias, if programmed as recommended.
Seidl et al. (1998) conducted an observational in Paroxysmal atrial tachyarrhythmias (n=45). Thera pacemaker atrial high rate episode diagnostic feature vs. Holter monitoring was evaluated on Detection of atrial tachyarrhythmias (sensitivity and specificity). The Thera pacemaker diagnostic algorithm demonstrated highly reliable detection of atrial tachyarrhythmias, achieving 98% sensitivity and 100% specificity when programmed with optimized settings.