The use of permanent pacemakers in the detection of cardiac arrhythmias

Aims To compare pacemaker telemetry with simultaneous Holter recordings in the diagnosis of atrial fibrillation and to evaluate the STOP-AF study tele metry criteria for the presence of atrial fibrillation. Methods and Results 18 consecutive patients enrolled in the STOP-AF study h ad simultaneous 24 h Holter recordings and down-loaded pacemaker telemetry. There was good agreement on heart rate, but thr STOP-AF pacemaker criteria achieved only 57% sensitivity with 64% specificity For the presence of atr ial fibrillation on Holter recording over 24 h. False-positives appeared to result from far-field sensing while false-negatives occurred with very sho rt episodes of atrial fibrillation. The pacemaker's antitachycardia respons es were not specific for the presence of atrial fibrillation. Conclusion Pacemaker telemetry is a potentially important sourer of data on cardiac arrhythmias. Further studies are required to define the limitation s of these data in specific devices before they can be interpreted with con fidence. (C) 2001 The European Society of Cardiology.