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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Diagnostic value of stored electrograms in single-lead VDD systems.
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Diagnostic value of stored electrograms in single-lead VDD systems.

机译：单引线VDD系统中存储的电描记图的诊断值。

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摘要

Evaluation of the quality of atrial sensing is indispensable to monitor the performance of VDD single-lead systems. In addition to counters, a new VDD system offers storage of intracardiac electrograms (EGMs). The clinical contribution of stored EGMs in a VDD pacemaker was prospectively examined in a multicenter study, and the reliability of its counters was evaluated on the basis of EGM information. METHODS: A VDD system (Pulsar 870, Guidant Co.) was implanted in 46 patients with atrioventricular block. EGM storage was activated upon detection of ventricular tachycardia (VT), recurrent premature ventricular complexes (PVCs), and mode switch ("atrial tachy reaction," ATR). Stored EGMs were retrieved before discharge of the patients from the hospital, and at 6-week, 3-month, and 6-month follow-up. RESULTS: A total of 440 stored EGMs were retrieved and analyzed. Of 30 VT episodes detected, 2 (7%) were confirmed, and all others were attributable to ventricular oversensing. One postmortem interrogation documented VT as the cause of sudden death. Of 175 EGMs stored upon detection of PVCs, 43 episodes (25%) were confirmed and 124 (70%) showed intermittent atrial undersensing with spontaneous AV conduction; in 8 episodes (5%) no abnormality was observed. Of 235 episodes stored upon ATR, 82 (35%) were confirmed and 153 were due to atrial oversensing. CONCLUSIONS: (1). Stored EGMs indicated a high percentage (69%) of event misdiagnosis by the pacemaker. Thus, pacemaker counter information without the availability of stored EGMs should be interpreted with caution. (2). Misclassified events are of high clinical importance since they unmask otherwise unsuspected intermittent under- or oversensing.
机译：评估VDD单引脚系统的性能必不可少的是对心房感应质量的评估。除计数器外，新的VDD系统还提供了心内电描记图（EGM）的存储。在多中心研究中前瞻性地检查了VDD起搏器中存储的EGM的临床贡献，并根据EGM信息评估了其计数器的可靠性。方法：将VDD系统（Pulsar 870，Guidant公司）植入46例房室传导阻滞患者中。在检测到室性心动过速（VT），复发性室性早搏复合物（PVC）和模式切换（“房速”，ATR）后，将激活EGM存储。在患者出院之前以及在6周，3个月和6个月的随访中，检索了存储的EGM。结果：共检索和分析了440个存储的EGM。在检测到的30例VT发作中，有2例（7％）被确认，其他所有归因于心室过度感应。一次验尸记录显示室速是猝死的原因。在检测到PVC时存储的175个EGM中，确认有43次发作（25％），有124次（70％）表现为间歇性房室感觉减退，并伴有自发性AV传导。 8例（5％）中未观察到异常。在ATR上存储的235次发作中，有82例（占35％）得到确认，其中153例是由于心房过度感应所致。结论：（1）。储存的EGM提示起搏器对事件的误诊率很高（69％）。因此，在没有存储的EGM的情况下，应仔细解释起搏器计数器信息。 （2）。错误分类的事件具有很高的临床重要性，因为它们可以掩盖原本不为人知的间歇性不足或过度感觉。

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