Key result
Intraatrial pacemaker stored electrograms identified that 62% of stored high atrial rate episodes were not true atrial tachyarrhythmias, while episodes >250 bpm and >5 minutes highly correlated with AF.
Why the study?
Are intraatrial electrograms required to accurately diagnose specific types of atrial tachyarrhythmias detected by pacemaker diagnostics in patients with DDD pacemakers?
Observational (n=56)
Are intraatrial electrograms required to accurately diagnose specific types of atrial tachyarrhythmias detected by pacemaker diagnostics in patients with DDD pacemakers?
Intraatrial stored electrograms are essential for accurately diagnosing atrial fibrillation and flutter from pacemaker diagnostics, as a majority of high atrial rate episodes may not be true tachyarrhythmias.
Electrograms needed to confirm true AF in pacemaker high-rate episodes; leaves open whether rate/duration thresholds alone suffice for diagnosis.
The purpose of this study was to determine if intraatrial electrograms (EGMs) are required to diagnose specific types of atrial tachyarrhythmias detected by pacemaker diagnostics. DDD pacemakers in 56 patients were programmed to store episodes of atrial tachyarrhythmias. Some episodes had a stored atrial EGM snapshot of the atrial tachyarrhythmia. The EGMs were analyzed to confirm whether the stored episodes were true atrial tachyarrhythmias or other pacemaker-sensed events. EGM confirmation of atrial tachyarrhythmias correlated with increasing duration and rate of episodes. In particular, using EGMs, 8 (18%) of 44 episodes < 10 seconds in duration confirmed atrial tachyarrhythmias compared to 16 (89%) of 18 episodes > 5 minutes in duration (P < 0.001). Only 10 (18%) of 56 detected atrial arrhythmia episodes at rates < 250 complexes per minute were confirmed by the atrial EGM as true arrhythmias compared to 33 (57%) of 58 detected episodes at rates > 250/min (P < 0.001) Twenty-nine (91%) of 32 EGM confirmed episodes of atrial fibrillation/flutter had an atrial rate > 250 complexes per minute and were a minimum of 10 seconds in duration. Fifteen (88%) of 17 episodes meeting the combined stored data criteria of > 250 complexes per minute and duration > 5 minutes were confirmed as atrial fibrillation or flutter by stored EGMs. Atrial EGMs identified that 71 (62%) of 114 stored high atrial rate (HAR) episodes were events other than true atrial tachyarrhythmias. Pacemaker diagnostic data with intraatrial EGMs can diagnose specific atrial tachyarrhythmias and identify other pacemaker-sensed events. Stored episodes > 250 complexes per minute and > 5 minutes in duration had a high correlation with atrial fibrillation and flutter.
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POLLAK et al. (2001) conducted an observational in Atrial fibrillation and flutter (n=56). Intraatrial pacemaker stored electrograms (EGMs) was evaluated on Confirmation of true atrial tachyarrhythmias. Intraatrial pacemaker stored electrograms identified that 62% of stored high atrial rate episodes were not true atrial tachyarrhythmias, while episodes >250 bpm and >5 minutes highly correlated with AF.
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