[The use of Holter electrocardiography in permanent pacemaker users]

Abstract

The authors selected 37 permanent pacemaker patients followed for eleven successive months, with symptomatology eventually related to the pacing system. An Holter ambulatory monitorization was performed to all of them during 24 hours. Twenty one had single chamber systems and the others double chamber. Twelve malfunctions were found in ten patients. Six due to "undersensing", 4 related to "oversensing", and 2 from loss of capture. Two patients had tachycardia pacemaker mediated. An inadequate mode of pacing was found in other two cases. Fifteen rhythm disturbances not related to the pacemaker systems were registered in thirteen patients: supra-ventricular in 9; ventricular greater than or equal to 3 degree of lown in 5; and 2nd degree A.V.B. Mobitz type I in one case. Four patients were submitted to surgical intervention in order to modify the mode of pacing. It was also necessary to reprogram ten patients. The Holter Ambulatory Electrocardiography revealed to be an important diagnostic method for the detection of intermittent malfunction of pacing systems. The occasional changes of cardiac rhythm not linked with pacing were also revealed.