Reliability and efficacy of a monitoring system for an implanted pulse generator

The Selection 900/900E is a physiological pacing device with a sophisticated monitoring system for detecting and analyzing atrial arrhythmias. We have investigated the reliability and efficacy of the Selection monitoring system. Twelve patients with episodes of atrial tachyarrhythmias were implanted the with Selection device (7 men, 5 women, aged 73 ± 6 years old). Ten patients had sick sinus syndrome and two patients had a high degree of atrioventricular (AV) block. All patients underwent 24-h external Holter monitoring after the operation (136 ± 41 days) to evaluate the accuracy of the data recorded by the internal monitoring system. There was no significant difference in counter data between the 24-h external Holter and the internal monitoring systems. Four patients recorded an episode of atrial fibrillation by both systems. In two patients, the 24-h external Holter monitoring system misread DDI pacing after mode switching as sinus rhythm or pacing failure. In another patient, the featured function of this pacing device for atrial tachyarrhythmia was recognized as a sensing failure by the 24-h external Holter monitoring system. The Selection 900/900E monitoring system is a reliable and informative way to evaluate the relevance of pacing therapy.