TY - JOUR
T1 - Diagnostic accuracy of pace spikes in the electrocardiogram to diagnose paced rhythm
AU - Andersson, Hedvig Bille
AU - Hansen, Marco Bo
AU - Thorsberger, Mads
AU - Biering-Sørensen, Tor
AU - Nielsen, Jonas Bille
AU - Graff, Claus
AU - Pehrson, Steen
AU - Svendsen, Jesper Hastrup
N1 - Copyright © 2015 Elsevier Inc. All rights reserved.
PY - 2015/9/1
Y1 - 2015/9/1
N2 - OBJECTIVE: To determine how often cardiac resynchronization therapy (CRT) pacing systems generate visible pace spikes in the electrocardiogram (ECG).METHODS: In 46 patients treated with CRT pacing systems, we recorded ECGs during intrinsic rhythm, atrial pacing and ventricular pacing. ECGs were analysed for atrial and ventricular pace spikes by two experienced ECG readers blinded to the pacing therapy and to the study purpose.RESULTS: Atrial pacing generated visible pace spikes in less than 70% of the ECGs, whereas ventricular pacing generated visible pace spikes in about 90% of ECGs. The sensitivity of manual ECG interpretation for pace spikes was low for atrial pacing (Reader 1: 0.62 [95% confidence interval (CI) 0.50-0.74]; Reader 2: 0.65 [95% CI 0.53-0.77]) and moderate for ventricular pacing (Reader 1: 0.88 [95% CI 0.81-0.93]; Reader 2: 0.93 [95% CI 0.87-0.97]).CONCLUSIONS: In patients with CRT pacing systems, the absence of visible pace spikes in the ECG does not rule out paced rhythm.
AB - OBJECTIVE: To determine how often cardiac resynchronization therapy (CRT) pacing systems generate visible pace spikes in the electrocardiogram (ECG).METHODS: In 46 patients treated with CRT pacing systems, we recorded ECGs during intrinsic rhythm, atrial pacing and ventricular pacing. ECGs were analysed for atrial and ventricular pace spikes by two experienced ECG readers blinded to the pacing therapy and to the study purpose.RESULTS: Atrial pacing generated visible pace spikes in less than 70% of the ECGs, whereas ventricular pacing generated visible pace spikes in about 90% of ECGs. The sensitivity of manual ECG interpretation for pace spikes was low for atrial pacing (Reader 1: 0.62 [95% confidence interval (CI) 0.50-0.74]; Reader 2: 0.65 [95% CI 0.53-0.77]) and moderate for ventricular pacing (Reader 1: 0.88 [95% CI 0.81-0.93]; Reader 2: 0.93 [95% CI 0.87-0.97]).CONCLUSIONS: In patients with CRT pacing systems, the absence of visible pace spikes in the ECG does not rule out paced rhythm.
U2 - 10.1016/j.jelectrocard.2015.07.005
DO - 10.1016/j.jelectrocard.2015.07.005
M3 - Journal article
C2 - 26278651
SN - 0022-0736
VL - 48
SP - 834
EP - 839
JO - Journal of Electrocardiology
JF - Journal of Electrocardiology
IS - 5
ER -