A Semi‐Automatic Device for Pacemaker Function Analysis

Abstract

An external semi-automatic Pacemaker Function Analyzer (PFA) has been designed for routine examination (screening) of ambulatory-paced patients in general medical practice. The evaluation of the pacemaker (PM) function is based on recognition, decoding, and measurement of the occurrence of QRS complexes and pacing artifacts, and on logic processing of the decoded data. In this way, the state of the batteries and the integrity of the electronic circuitry and the electrodes can be determined. Other PFA applications concern supervision of hospitalized patients by interfacing the analyzer with the monitoring system of a Coronary Care Unit (CCU), transtelephone checking, and adaptation for use in specialized pacemaker clinics. The performance of the PFA was checked on 92 ambulatory patients. The PFA system recognized all but 0.29% of the QRS complexes and 0.21% of the pacing artifacts. Thirty-two of these patients were tested simultaneously by the PFA and the pacemaker clinic physician, both arriving at the same results. Twelve hospitalized patients were monitored in the CCU, after permanent PM implantation, for an average of 4 hours per patient. Although the PFA indicated 5% false-negative alarms for the hospitalized patients, it should be stressed that every true PM failure was promptly detected. It is anticipated that routine use of the PFA for management of paced patients will reduce the expenses incurred by frequent visits, as well as simplify the follow-up and surveillance of ambulatory and hospitalized patients, thereby facilitating the work of the medical staff.