The development of a dual-sensor diagnostic pacemaker allows for simultaneous monitoring of intracardiac ECG and intraventricular pressure to better diagnose unexplained blackouts.
May aid syncope evaluation in ambulatory settings; hypothesis-generating pending prospective validation before clinical use.
Unexplained blackouts are a very common medical problem. Some patients presenting themselves at hospital with such symptoms have underlying bradycardia or extreme tachycardia with a profound decrease in cardiac output. Modern treatment of these patients may be highly effective but accurate diagnosis of their exact condition may be needed. A novel ambulatory dual-sensor diagnostic pacemaker has been developed to meet this requirement. The device monitors intracardiac ECG and intraventricular pressure through a special lead introduced perveneously into the right ventricle and detects and counts events such as bradycardia, tachycardia, pauses in the electrical or pressure signals and electrical interference. Analogue recordings of the electrical and pressure waveforms of 16 of these events can be made during the operating period of 3 weeks and pacing is incorporated via a specially-adapted commercial pacemaker if a prolonged episode of bradycardia or a pause is sensed. The device forms part of a complete diagnostic system also incorporating a computer which is used to set up the parameters of the diagnostic pacemaker and to display and analyse the recorded data.
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Shaw et al. (1990) studied this question.
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