Computer analysis of implanted cardiac pacemaker rhythm

Implanted cardiac pacemakers are becoming more sophisticated. However, accurate detection of pacemaker stimuli is a problem for most ECG machines because of the very short duration of the stimuli, sometimes only 0.3 ms. In addition, the relatively new technique of biventricular pacing involves two closely timed stimuli to activate the ventricles separately. Detection of all stimuli in a paced patient is therefore becoming increasingly difficult for conventional ECG machines. In order to address this problem, a more recently developed electrocardiograph, namely the Burdick Atria 6100, introduced enhanced front end electronics. This study assessed its accuracy in detecting pacemaker stimuli and assessed the choice of lead for their detection. 51 patients were initially recruited. Five were excluded for various reasons. Pacemaker activity was detected in 45/46 patients and in 16/16 patients with biventricular pacemakers, two closely paced stimuli were detected.