Evaluation of the extended Holter capabilities of the Prometheus implantable research pacemaker

An arrhythmia detection program for the implantable Medtronic Prometheus research pacemaker was evaluated by making it analyze interval sequences from Holter tapes already evaluated by the ATREC Holter analysis system. Eight 10-minute periods from 24-hour Holter tapes from 4 patients were selected, as they presented ventricular arrhythmias ranging from extrasystoles to sustained tachycardia. Twenty-nine tests were performed with various combinations of diagnostic parameters. One-to-one correlation between ATREC and Prometheus analyses was observed in 23 cases. Discrepancies could be explained by a difference in algorithm design (5 cases) and a round-off effect (1 case). Prometheus also missed two isolated premature beats which could not be explained. The differences in results are not considered major, and it can be concluded that the intended arrhythmia detection and classification in implantable devices is feasible