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Advanced algorithms can lead to electrocardiographic misinterpretations

  • Author Footnotes
    1 Postal Address: Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, Università degli Studi di Napoli “Federico II”. Via Pansini no. 5, Ed. 2; 80131 Naples, Italy.
    Salvatore Luca D'Ascia
    Footnotes
    1 Postal Address: Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, Università degli Studi di Napoli “Federico II”. Via Pansini no. 5, Ed. 2; 80131 Naples, Italy.
    Affiliations
    Department of Clinical Medicine, Cardiovascular and Immunologic Sciences, University of Naples “Federico II”, Italy
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  • Author Footnotes
    1 Postal Address: Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, Università degli Studi di Napoli “Federico II”. Via Pansini no. 5, Ed. 2; 80131 Naples, Italy.
    Gaetano Santulli
    Footnotes
    1 Postal Address: Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, Università degli Studi di Napoli “Federico II”. Via Pansini no. 5, Ed. 2; 80131 Naples, Italy.
    Affiliations
    Department of Clinical Medicine, Cardiovascular and Immunologic Sciences, University of Naples “Federico II”, Italy
    Search for articles by this author
  • Author Footnotes
    1 Postal Address: Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, Università degli Studi di Napoli “Federico II”. Via Pansini no. 5, Ed. 2; 80131 Naples, Italy.
    Vincenzo Liguori
    Footnotes
    1 Postal Address: Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, Università degli Studi di Napoli “Federico II”. Via Pansini no. 5, Ed. 2; 80131 Naples, Italy.
    Affiliations
    Department of Clinical Medicine, Cardiovascular and Immunologic Sciences, University of Naples “Federico II”, Italy
    Search for articles by this author
  • Author Footnotes
    1 Postal Address: Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, Università degli Studi di Napoli “Federico II”. Via Pansini no. 5, Ed. 2; 80131 Naples, Italy.
    Vittoria Marino
    Footnotes
    1 Postal Address: Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, Università degli Studi di Napoli “Federico II”. Via Pansini no. 5, Ed. 2; 80131 Naples, Italy.
    Affiliations
    Department of Clinical Medicine, Cardiovascular and Immunologic Sciences, University of Naples “Federico II”, Italy
    Search for articles by this author
  • Author Footnotes
    1 Postal Address: Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, Università degli Studi di Napoli “Federico II”. Via Pansini no. 5, Ed. 2; 80131 Naples, Italy.
    Claudia Arturo
    Footnotes
    1 Postal Address: Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, Università degli Studi di Napoli “Federico II”. Via Pansini no. 5, Ed. 2; 80131 Naples, Italy.
    Affiliations
    Department of Clinical Medicine, Cardiovascular and Immunologic Sciences, University of Naples “Federico II”, Italy
    Search for articles by this author
  • Author Footnotes
    1 Postal Address: Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, Università degli Studi di Napoli “Federico II”. Via Pansini no. 5, Ed. 2; 80131 Naples, Italy.
    Massimo Chiariello
    Footnotes
    1 Postal Address: Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, Università degli Studi di Napoli “Federico II”. Via Pansini no. 5, Ed. 2; 80131 Naples, Italy.
    Affiliations
    Department of Clinical Medicine, Cardiovascular and Immunologic Sciences, University of Naples “Federico II”, Italy
    Search for articles by this author
  • Author Footnotes
    1 Postal Address: Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, Università degli Studi di Napoli “Federico II”. Via Pansini no. 5, Ed. 2; 80131 Naples, Italy.
    Cristoforo D'Ascia
    Correspondence
    Corresponding author. Department of Clinical Medicine, Cardiovascular and Immunologic Sciences, Via Sergio Pansini, 5-Ed. 2; 80131 Naples, Italy. Tel./fax: +39 081 7463075.
    Footnotes
    1 Postal Address: Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, Università degli Studi di Napoli “Federico II”. Via Pansini no. 5, Ed. 2; 80131 Naples, Italy.
    Affiliations
    Department of Clinical Medicine, Cardiovascular and Immunologic Sciences, University of Naples “Federico II”, Italy
    Search for articles by this author
  • Author Footnotes
    1 Postal Address: Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, Università degli Studi di Napoli “Federico II”. Via Pansini no. 5, Ed. 2; 80131 Naples, Italy.
Published:January 12, 2009DOI:https://doi.org/10.1016/j.ijcard.2008.11.144

      Abstract

      We observed a patient with syncope, who implanted a pacemaker with advanced algorithms such as “atrial-tachy response” and “dynamic atrio-ventricular delay”. After one year, conventional ECG Holter showed pacemaker malfunction, wrongly attributed to exposure to electromagnetic field. In fact, telemetry revealed an inappropriate programming and solved our case. Holter monitoring is commonly performed in the evaluation of pacemaker malfunction, albeit it remains a quite shallow diagnostic method especially to detect electromagnetic interferences. New algorithms seem important, but it is reasonable to obtain more suitable analytical tools, too.

      Keywords

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      References

        • Chongtham D.S.
        • Bahl A.
        • Kumar R.M.
        • Talwar K.K.
        Inappropriate shock delivery by implantable cardioverter defibrillator due to electrical interference electrical interference with washing machine.
        Int J Cardiol. 2007; 118: e44
        • Thaker J.P.
        • Patel M.B.
        • Jongnarangsin K.
        • Liepa V.V.
        • Thakur R.K.
        Electromagnetic interference with pacemakers caused by portable media players.
        Heart Rhythm. 2008; 5: 538
        • Trigano A.
        • Blandeau O.
        • Dale C.
        • Wong M.F.
        • Wiart J.
        Risk of cellular phone interference with an implantable loop recorder.
        Int J Cardiol. 2007; 116: 126
        • Nowak B.
        • Henry S.
        • Mols R.
        • Maertens S.
        • Coenen M.
        • Meyer J.
        Holter recordings with continuous marker annotation to evaluate pacemaker function.
        Ann Noninvasive Electrocardiol. 2002; 7: 22
        • Vardas P.E.
        • Auricchio A.
        • Blanc J.J.
        • et al.
        Guidelines for cardiac pacing and cardiac resynchronization therapy. The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in collaboration with the European Heart Rhythm Association.
        Europace. 2007; 9: 959
        • Sweesy M.W.
        Understanding electromagnetic interference.
        Heart Rhythm. 2004; 1: 523
        • Coats A.J.
        Ethical authorship and publishing.
        Int J Cardiol. 2009; 131: 149-150