What does this research mean for the field?

Telemetered atrial endocardial electrograms can identify intermittent far-field atrial sensing of ventricular depolarization when surface electrocardiography misdiagnoses the arrhythmia as ventricular tracking of occult atrial ectopy. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

October 1, 1988Pacing and Clinical Electrophysiology

Utility of the Atrial Endocardial Electrogram Concurrent with Dual‐Chamber Pacing in the Determination of a Pacemaker‐Mediated Arrhythmia

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Complete heart block and pacemaker-mediated arrhythmia (n=1). Intervention: Telemetered atrial electrogram (EGM) vs. Surface electrocardiography. Primary outcome: Diagnosis of pacemaker-mediated arrhythmia.

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Key result

Telemetered atrial EGM corrects surface ECG misdiagnosis by revealing far-field sensing of ventricular depolarization.

Why the study?

Does telemetered atrial electrogram improve the diagnosis of pacemaker-mediated arrhythmias compared to surface electrocardiography in patients with dual-chamber pacemakers?

Population

A 73-year-old male with complete heart block requiring a permanent pacemaker

Comparison

Telemetered atrial electrogram concurrent with… vs Surface electrocardiography

Design

Case_report

Authors

ASAdrian H. ShandlingUniversity of California, Irvine MCMark J. CastellanetLong Beach Memorial Medical Center JMJohn C. MessengerInterventional Cardiology

Discussion

Member takes

Implication

May clarify ECG-misdiagnosed pacemaker arrhythmias; leaves open prospective validation in dual-chamber devices.

Study Design

Type

Case Report (n=1)

Structured PICO

Does telemetered atrial electrogram improve the diagnosis of pacemaker-mediated arrhythmias compared to surface electrocardiography in patients with dual-chamber pacemakers?

Population

A 73-year-old male with complete heart block who developed a pacemaker-mediated arrhythmia after placement of a dual-chamber pacemaker.

Intervention

Telemetered atrial electrogram (EGM) concurrent with dual-chamber pacing

Comparator

Surface electrocardiography

Outcome

Diagnosis of the mechanism of pacemaker-mediated arrhythmia

Telemetered atrial electrograms are valuable for accurately diagnosing pacemaker-mediated arrhythmias that may be misdiagnosed on surface ECG.

Cite This Study

Shandling et al. (1988) conducted a case report in Complete heart block and pacemaker-mediated arrhythmia (n=1). Telemetered atrial electrogram (EGM) vs. Surface electrocardiography was evaluated on Diagnosis of pacemaker-mediated arrhythmia. Telemetered atrial electrogram revealed intermittent far-field atrial sensing of terminal ventricular depolarization, correcting the misdiagnosis of ventricular tracking made by surface ECG.

synapsesocial.com/papers/6aa7eb18ff0084718cb186be https://doi.org/10.1111/j.1540-8159.1988.tb04990.x

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Utility of the Atrial Endocardial Electrogram Concurrent with Dual‐Chamber Pacing in the Determination of a Pacemaker‐Mediated Arrhythmia

Discussion

Member takes

Implication

Study Design

Structured PICO

Cite This Study

Utility of the Atrial Endocardial Electrogram Concurrent with Dual‐Chamber Pacing in the Determination of a Pacemaker‐Mediated Arrhythmia

Discussion

Member takes

Implication

Study Design

Structured PICO

Cite This Study

Also Consider

Also Consider