Use of computer simulation in the development of an algorithm for analysis of paced electrocardiograms

A computer model of the interaction between heart and artificial pacemaker is developed which simulates a variety of dual-chamber device responses in the context of 25 possible arrhythmia classes. The heart-pacemaker interaction (HPI) model includes specifications of cardiac, pacemaker, and noise distribution parameters which permit random simulation of pacemaker failure. It simulates random pacemaker output, capture, and sensing malfunctions. The model has been used to train an automated, knowledge-based algorithm designed to analyze paced electrocardiograms for pacemaker function and malfunction. By allowing the straightforward simulation of numerous arrhythmia/pacemaker failure scenarios, the model has significantly reduced the amount of clinical testing and therefore the development time otherwise required