Pacemaker syndrome other diagnostic studies
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]
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Pacemaker Interrogation
Diagnosis of pacemaker syndrome should start with pacemaker interrogation. It includes:
- Ruling out excessive ventricular pacing
- Looking for AV dissociation/VA conduction
- Looking for pacemaker malfunctioning, battery life and mode reversal
Other methods to diagnose Pacemaker Syndrome includes:
- Measuring systolic time intervals
- Measuring finger pulse amplitude by strain gauge
- Correlating cardiac index with pulse pressure
- Cuff blood pressure responses to different modes of pacing
Holter Monitoring
- Holter monitoring can be used to correlate patients' symptoms with their cardiac rhythm and is considered the best method of diagnosing pacemaker syndrome.
Blood Pressure Monitoring
- Systolic blood pressure should be measured during ventricular pacing and should be compared with that during atrial or AV synchronous pacing.
- A drop of 20 mm Hg or more suggests pacemaker syndrome.