Enhanced software based detection of implanted cardiac pacemaker stimuli

With increasing use and sophistication of implantable cardiac pacemaker devices, new techniques are required to ensure accurate detection of pacemaker stimuli. This study aimed to (i) compare the accuracy of enhanced pacemaker spike detection logic using 32,000 samples/sec (sps) data against existing software based on current AAMI/IEC standards; (ii) assess the ability of the new logic to aid in the detection of biventricular (BiV) pacing; (iii) develop and test a method for the detection of BiV pacing based on QRS morphology. 72 patients were recruited. 63 were used to assess spike detection accuracy and 62 to assess the accuracy of reporting BiV pacing. 33/62 had BiV pacemakers. 9 patients were excluded for various reasons. The new logic improved accuracy of spike detection from 46/63 to 62/63. For BiV pacing, the new logic had a sensitivity of 97% and a specificity of 100% while the QRS morphology logic had a sensitivity of 70% and a specificity of 93%.