Diagnosis of paced electrocardiograms by inverse computer modeling of pacemaker actions

Cardiac electrophysiological experiments in numero, Part III: Simulation of arrhythmias and pacing

This paper is the third and final part of a series of articles reviewing mathematical and computer models of the electrophysiological processes. This section reviews the arrhythmia simulation and discusses models of arrhythmogenic processes, fibrillation and defibrillation, and of heart-pacemaker interaction. The models of arrhythmogenesis are classified into three main sections: models of reentry and vortex reentry, models of myocardial electrotonic interactions, and models of macroreentrant supraventricular tachycardias. This final part of the review discusses the future potential of mathematical and computer models of different cardiac processes.

Computerized interpretation of the paced ECG

Analysis of the paced electrocardiogram (ECG) is important to the follow-up evaluation of patients with implanted pacemakers. Because of the complexity and variability of pacemaker algorithms, diagnosis of paced ECGs is often considerably more difficult than the interpretation of usual ECGs. Automated interpretation of the paced ECG can provide great clinical benefit because few clinicians are adequately trained in the diagnosis of such ECGs for the interpretation of pacemaker functionality. However, comparatively little work has been done in this area, mainly because the diversity and complexity of pacemaker logic makes interpretation, automated or manual, a difficult task. The following paper reviews research in computer interpretation of the pacemaker ECG and presents a new automated method which yields more detailed and accurate results than any previous technique.