Performance study of digital pacer spike detection as sampling rate changes

Abstract

In this study, we first collected ECG data at 32 ksps and 500 sps from 51 patients with an implanted cardiac pacemaker. We also included 16 non paced ECGs with severe motion artifact and static interference. We then annotated the pacer pulses (locations and classifications) using special viewing software and divided the data into training and testing sets. We developed three digital pacemaker stimulus detection algorithms, one for each of three different sampling rates (500 sps, 8 ksps, and 32 ksps) by using similar detection concepts. After tuning them on the training sets at the corresponding sampling rates, we investigated their performances. Results showed that the detection algorithm based on the 12-lead 500-sps data stream has a good performance (Sensitivity or Se=77.51%; Positive Productive Value, or +P=90.32%). The 8-ksps detector has a better performance (Se=95.37; +P=99.77). The digital pacemaker detection algorithm for 32 ksps or higher data provided almost 100% true pacer spike detection (Se=99.51 and +P=100%). In summary, high speed sampling at 32ksps can provide accurate detection of modern pacers and leads to a significant improvement in detection of pacemaker stimuli compared to the reduced sampling rates used previously.

Precise pacing artefact detection

“…As mentioned in [5], the high sampling rate allows us to much more accurately detect PA than data acquired at a lower sampling rate. UHF ECG analysis uses frequencies up to 2 kHz.…”

Implanted cardiac pacemaker pulses as recorded from the body surface

“…This new technology can significantly improve the body surface pacemaker detection accuracy. 7,8 Recently, this solution has become a standard form of design for a contemporary high-end ECG device and a similar high-sampling rate schema for pacer detection from the body surface is now employed by other ECG manufacturers (e.g., Reference 9 ).…”

Digital pacer detection in diagnostic grade ECG

“…Modern pacemakers generate pulses of 2-5 mV which last for about 0.5-2 ms in an ECG recording. Reliable detection of the pacing pulses, thus necessitates, high sampling rates (4-16 kHz) in order to capture enough energy from the narrow pulses [6], [7]. Several detection schemes are possible with the basic event detection (or sensing) algorithm remaining more or less unchanged, based on high-pass filtering followed by an amplitude threshold [7].…”

“…2 shows the possible stages for pacer detection. Pacemaker pulses in the ECG are high frequency signals, and their detection has traditionally been done in the front-end of electrocardiograph devices, on high bandwidth signals [6]. Some devices use analog circuitry to detect the large signal slew-rates typical of pacemaker pulses.…”