Taking advantage of sophisticated pacemaker diagnostics

The ever-increasing complexity of pacing systems, combined with functions that vary from one manufacturer to another, can pose challenges during analysis of device function. Standard pacemaker diagnostics are measured data, electrogram telemetry, marker annotations and event counters, albeit with their current limitations. New diagnostic features discussed include time-based diagnostics, histograms of sensed amplitudes, pacing thresholds, or impedance trending. Mode-switching algorithms, combined with diagnostic features, facilitate the use of dual-chamber devices in patients with paroxysmal atrial tachyarrhythmias. The introduction of electrogram storage into pacemakers further improves diagnostic capabilities and allows a permanent validation and optimization of diagnostic and therapeutic algorithms. External diagnostic devices, which provide Holter recordings with continuous marker annotations and patient-triggered diagnostics, are additional features that will become increasingly important.