Abstract

PELLEGRINO, Graciela M. M. et al. Usefulness of Stored Electrograms in Patients with Permanent Pacemakers for the Assessment of Arrhythmias and Therapeutic Decision Making. Rev. argent. cardiol. [online]. 2006, vol.74, n.6, pp.372-376. ISSN 1850-3748.

Background and Objective With the advent of the new generation of permanent pacemakers with event storage capabilities (PMSC), a new diagnostic tool is available for patient follow-up. The present study was conducted with the objective of assessing rhythm disturbances in patients with PMSC. Material and Methods In 53 consecutive patients, followed from June 2002 until January 2004, the collection of electrograms (EG) was activated at the time of pacemaker implant and thus the need for therapeutic intervention was assessed. Follow-up period was 8 ± 6 months; 39 pacemakers were DDD mode and 14 were VDD, in all of them electrogram collection was activated. Recordings showing generator malfunction were excluded as well as those with a questionable diagnosis due to lack of onset of the arrhythmia. Results In the tracings analyzed, 20 atrial sustained arrhythmias were detected (atrial fibrillation, 11; atrial tachycardia or flutter, 9), 3 sustained ventricular tachycardias (VT), 3 nonsustained VT's and 2 pacemaker-mediated tachycardias. In all the arrhythmias found, a single or combined therapeutic intervention was decided: radiofrequency ablation in 4, pharmacological treatment in 22, and in 37 the arrhythmia required pacemaker reprogramming. Conclusion The analysis of stored electrograms is a very useful tool to assess the occurrence of arrhythmic events and decide therapeutic conducts.

Keywords : Artificial pacemaker; Electrophysiology; Arrhythmia.