Automatic mode switching algorithms in permanent pacemakers accurately detected atrial tachyarrhythmias with 98.1% sensitivity and 100% specificity compared to Holter monitoring.
Observational (n=40)
Does automatic mode switching accurately detect atrial tachyarrhythmias compared to Holter monitoring in patients with permanent pacemakers?
Automatic mode switching algorithms in permanent pacemakers are highly accurate surrogate markers for detecting atrial tachyarrhythmias.
INTRODUCTION: In patients with permanent pacemakers, mode switching events often are interpreted as surrogate markers for atrial tachyarrhythmias. The aim of this study was to determine the accuracy of automatic mode switching algorithms in patients with permanent pacemakers for the diagnosis of atrial tachyarrhythmias. METHODS AND RESULTS: Forty patients with tachycardia-bradycardia syndrome and Medtronic Thera or Kappa 700 permanent pacemakers underwent Holter monitoring. Date, time of onset, and duration of each mode switch episode as recorded by the pacemaker and each atrial tachyarrhythmia episode as recorded by the Holter monitor were compared. Sixteen patients had a total of 54 atrial tachyarrhythmias documented on Holter monitoring (47 atrial fibrillation, 7 atrial flutter). Comparison of Holter data with pacemaker interrogation demonstrated that 53 (98.1%) of 54 atrial tachyarrhythmia episodes resulted in mode switching with one 13-second episode of mode switching during sinus rhythm. The sensitivity and specificity of mode switching for the duration of atrial tachyarrhythmias were 98.1% and 100%, respectively. The algorithms detected 98.9% of the total duration of atrial fibrillation and 96.4% of the total duration of atrial flutter. CONCLUSION: In patients with tachycardia-bradycardia syndrome and permanent pacemakers having these mode switching algorithms, mode switching events are reliable surrogate markers for atrial tachyarrhythmias. Therefore, mode switching may serve as a valuable tool for clinical decision making and further research into the natural history and burden of atrial tachyarrhythmias.
Passman et al. (Thu,) conducted a observational in Tachycardia-bradycardia syndrome (n=40). Automatic mode switching algorithms vs. Holter monitoring was evaluated on Detection of atrial tachyarrhythmias. Automatic mode switching algorithms in permanent pacemakers accurately detected atrial tachyarrhythmias with 98.1% sensitivity and 100% specificity compared to Holter monitoring.