Diagnostic accuracy of pace spikes in the electrocardiogram to diagnose paced rhythm

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 -