Improved pacemaker pulse detection: clinical evaluation of a new high-bandwidth electrocardiographic system

Abstract Background This study compares the pacemaker pulse detection performance of the new high-bandwidth (hi-fi) electrocardiographic (ECG) acquisition system to a conventional system in a prospective clinical evaluation. Methods Electrocardiograms from 88 subjects with implanted pacemakers were recorded using different pacemaker programmed outputs and with different noise levels. Each ECG was recorded simultaneously from both systems. A cardiologist independently confirmed the clinically relevant ECGs. The pacemaker pulse detection sensitivity and positive predictive value (PPV) of each system were computed. The efficacy of each system was evaluated using a z test. Results For the independently confirmed reports, the hi-fi system was superior, with higher sensitivity (99.2% vs 83.2%, P P = .33), for the detection of pacemaker pulses. Conclusion In a large group of subjects with implanted pacemakers and even in noisy conditions, the new hi-fi system was shown to improve pacemaker pulse detection sensitivity and PPV.