Summary
Recent progress in computer technology has enabled the design of software-guided pacemakers. Earlier devices offered only 1 or 2 diagnostic functions, such as pacing threshold measurement and telemetry of the intracardiac electrogram. Software pacemakers like the DPG 1 (Vitatron) have a whole variety of analysis functions.
The aim of the study was to investigate the clinical reliability of the DPG 1’s analysis functions for pacemaker adjustment and follow-up. Twenty-three patients (3 female, 20 male) with symptomatic bradyarrhythmias were treated with the DPG 1 and a Helifix lead (AAI, n = 4; VVI, n = 19). A HP 85 personal computer was used for the 300 pacemaker telemetries. The telemetry procedure lasted 20 ± 5 minutes, for trained users also. The DPG 1-HP 85 system offers the following analysis functions: telemetry of the programmed parameters, R- and P-wave amplitude, pacing threshold, lead impedance and battery/output status.
The repeatedly performed threshold measurements revealed an accuracy of ± 0.05% and a variability of ≧ 50% at very low threshold values. Due to the simplicity, reliability and the strength-duration curve, threshold-guided pacing was possible in each patient. Examination of the lead impedance revealed an accuracy of ± 10% and a variability of ± 10%. The telemetry of the R-wave amplitude had an accuracy of ± 0.5 mV and a variability of ± 1.0 mV.
The telemetry functions were of great help for the adjustment of the pacemaker and the treatment of pacemaker dysfunctions. To apply the pacemakers and program functions correctly special training is necessary. Diagnostic pacemakers like the DPG 1 are considered to be an intermediate stage of development towards autodiagnostic pacemakers.
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References
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Winter, U.J., Behrenbeck, D.W., Brill, T., Höher, M., Hilger, H.H. (1985). Clinical Evaluation of a Diagnostic Pulse Generator (DPG) with Special Analysis Functions in Pacemaker Patient Follow-up. In: Behrenbeck, D.W., Sowton, E., Fontaine, G., Winter, U.J. (eds) Cardiac Pacemakers. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-662-06210-4_3
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DOI: https://doi.org/10.1007/978-3-662-06210-4_3
Publisher Name: Steinkopff, Heidelberg
Print ISBN: 978-3-662-06212-8
Online ISBN: 978-3-662-06210-4
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