Open Access Peer-reviewed Research Article

Pacemaker Interrogation Reports: Comparing Diagnostics, Lead Impedance, Pacing Thresholds and Battery Performance

Main Article Content

Samikshya Neupane
Tarun Goswami corresponding author

Abstract

Pacemakers are critical in managing cardiovascular arrhythmias, yet device malfunctions remain a significant clinical challenge, impacting patient safety and outcomes. This study presents a structured comparison of pacemaker interrogation reports from three leading manufacturers: Abbott referred to as Manufacturer A/A Devices, Boston Scientific as Manufacturer B/B Devices and Medtronic as Manufacturer C/C Devices focusing on battery performance, lead functionality, pacing modes, and arrhythmia management. By analyzing the interrogated data, device reliability, longevity, and diagnostic capabilities of the devices are understood. Data were categorized and compared with each other to assess performance trends and clinical usability. Results revealed significant variations in battery longevity, lead performance monitoring, and arrhythmia detection capabilities among the devices. Manufacturer C interrogation reports provide trend analysis and battery life management whereas Manufacturer A provide real-time diagnostics and alerts, and Manufacturer B reports demonstrated long-term stability and efficiency. The findings highlight the need for standardized reporting practices across manufacturers to enhance data consistency, comparability, and clinical utility. Such standardization would streamline clinician workflows, improve decision-making, and ultimately higher patient outcomes. This study underscores the importance of real-world data to optimize pacemaker management and calls for collaborative efforts among manufacturers, clinicians, and regulators to develop unified reporting frameworks. By integrating predictive analytics and remote monitoring capabilities, future advancements in pacemaker achieve higher patient care and device performance.

Keywords
pacemakers, cardiovascular arrhythmias, interrogation reports, medtronic, Abbott, Boston Scientific

Article Details

How to Cite
Neupane, S., & Goswami, T. (2025). Pacemaker Interrogation Reports: Comparing Diagnostics, Lead Impedance, Pacing Thresholds and Battery Performance. Research on Intelligent Manufacturing and Assembly, 4(1), 144-167. https://doi.org/10.25082/RIMA.2025.01.002

References

  1. American Heart Association. “Why would I need one?”, 2021. https://www.heart.org
  2. Aquilina O. A brief history of cardiac pacing. Images in paediatric cardiology. 2006, 8(2): 17. https://pmc.ncbi.nlm.nih.gov/articles/PMC3232561
  3. Shivi A, Shinde RK. Smart Pacemaker: A Review. Cureus. 2022, 14(10). https://doi.org/10.7759/cureus.30027
  4. Ward C, Henderson S, Metcalfe NH. A short history on pacemakers. International Journal of Cardiology. 2013, 169(4): 244-248. https://doi.org/10.1016/j.ijcard.2013.08.093
  5. Kalra J, Lightner NJ, Taiar R. (Eds.). Advances in Human Factors and Ergonomics in Healthcare and Medical Devices: Proceedings of the AHFE 2021 Virtual Conference on Human Factors and Ergonomics in Healthcare and Medical Devices, July 25–29, 2021, USA. Springer. https://doi.org/10.1007/978-3-030-80744-3
  6. Shepard RK, Ellenbogen KA. Leads and longevity: how long will your pacemaker last? Europace. 2008, 11(2): 142-143. https://doi.org/10.1093/europace/eun359
  7. Maisel WH, Moynahan M, Zuckerman BD, et al. Pacemaker and ICD generator malfunctions: analysis of Food and Drug Administration annual reports. Jama. 2006, 295(16): 1901-1906. https://doi.org/10.1001/jama.295.16.1901
  8. Ferrick AM, Raj SR, Deneke T, et al. 2023 HRS/EHRA/APHRS/LAHRS expert consensus statement on practical management of the remote device clinic. Heart Rhythm. 2023, 20(9): e92-e144. https://doi.org/10.1016/j.hrthm.2023.03.1525
  9. Piccini JP, El-Chami M, Wherry K, et al. Contemporaneous Comparison of Outcomes Among Patients Implanted With a Leadless vs Transvenous Single-Chamber Ventricular Pacemaker. JAMA Cardiology. 2021, 6(10): 1187. https://doi.org/10.1001/jamacardio.2021.2621
  10. Burri H, Senouf D. Remote monitoring and follow-up of pacemakers and implantable cardioverter defibrillators. Europace. 2009, 11(6): 701-709. https://doi.org/10.1093/europace/eup110
  11. Slotwiner D, Varma N, Akar JG, et al. HRS Expert Consensus Statement on remote interrogation and monitoring for cardiovascular implantable electronic devices. Heart Rhythm. 2015, 12(7): e69-e100. https://doi.org/10.1016/j.hrthm.2015.05.008
  12. Shanmugam DK, Anitha SC, Souresh V, et al. Current advancements in the development of bionic organs using regenerative medicine and 3D tissue engineering. Materials Technology. 2023, 38(1). https://doi.org/10.1080/10667857.2023.2242732
  13. Schaldach M. Electrotherapy of the heart: technical aspects in cardiac pacing. Springer Science & Business Media, 2012.
  14. Salih A M. Characterization of in-vivo damage in implantable cardiac devices and the lead residual properties. Wright State University, 2019. https://corescholar.libraries.wright.edu/etd_all
  15. Marras E, Sciarra L, Bocchino M, et al. Pacemaker malfunctions in Danon's disease. Pacing and Clinical Electrophysiology, 2008, 31(1): 125-128. https://doi.org/10.1111/j.1540-8159.2007.00937.x
  16. Atlee JL. Pacemaker Malfunction in Perioperative Settings. In: Atlee, J.L., Gombotz, H., Tscheliessnigg, K.H. (eds) Perioperative Management of Pacemaker Patients. Springer, Berlin, Heidelberg, 1992. https://doi.org/10.1007/978-3-642-76531-5_18
  17. Sabbagh E, Abdelfattah T, Karim M, et al. Causes of Failure to Capture in Pacemakers and Implantable Cardioverter-defibrillators. Journal of Innovations in Cardiac Rhythm Management. 2020, 11(2): 4013-4017. https://doi.org/10.19102/icrm.2020.110207
  18. Goswami T. Investigation of Retrieved Cardiac Devices. Biomedical Journal of Scientific & Technical Research. 2019, 23(4). https://doi.org/10.26717/bjstr.2019.23.003924
  19. Salih A, Goswami T. Residual properties of silicone (MED-4719) lead with leads from retrieved devices. Materials Engineering Research. 2022, 4(1): 236-244. https://doi.org/10.25082/mer.2022.01.005
  20. Mulpuru SK, Madhavan M, McLeod CJ, et al. Cardiac pacemakers: function, troubleshooting, and management: part 1 of a 2-part series. Journal of the American College of Cardiology. 2017, 69(2): 189-210. https://doi.org/10.1016/j.jacc.2016.10.061
  21. Rockland R, Parsonnet V, Myers GH. Failure modes of American pacemakers—in vitro analysis. American Heart Journal. 1972, 83(4): 481-492. https://doi.org/10.1016/0002-8703(72)90039-7
  22. Sabbagh E, Abdelfattah T, Karim M, et al. Causes of Failure to Capture in Pacemakers and Implantable Cardioverter-defibrillators. Journal of Innovations in Cardiac Rhythm Management. 2020, 11(2): 4013-4017. https://doi.org/10.19102/icrm.2020.110207
  23. Willy K, Ellermann C, Reinke F, et al. The Impact of Cardiac Devices on Patients’ Quality of Life — A Systematic Review and Meta-Analysis. Journal of Cardiovascular Development and Disease. 2022, 9(8): 257. https://doi.org/10.3390/jcdd9080257
  24. Mulpuru SK, Madhavan M, McLeod CJ, et al. Cardiac pacemakers: function, troubleshooting, and management: part 1 of a 2-part series. Journal of the American College of Cardiology. 2017, 69(2): 189-210. https://doi.org/10.1016/j.jacc.2016.10.061
  25. Mond HG. The Development of Pacemaker Programming: Memories From a Bygone Era. Heart, Lung and Circulation. 2021, 30(2): 233-239. https://doi.org/10.1016/j.hlc.2020.08.006
  26. Paglia E, Carter J. Cardiac Pacemakers. Hospital Medicine Clinics. 2017, 6(3): 374-396. https://doi.org/10.1016/j.ehmc.2017.04.007
  27. Davies G, Siddons H. Prediction of battery depletion in implanted pacemakers. Thorax. 1973, 28(2): 180-182. https://doi.org/10.1136/thx.28.2.180
  28. Davies G, Siddons H. Prediction of battery depletion in implanted pacemakers. Thorax. 1973, 28(2): 180-182. https://doi.org/10.1136/thx.28.2.180
  29. Munawar DA, Mahajan R, Linz D, et al. Predicted longevity of contemporary cardiac implantable electronic devices: A call for industry-wide “standardized” reporting. Heart Rhythm. 2018, 15(12): 1756-1763. https://doi.org/10.1016/j.hrthm.2018.07.029
  30. Paratz ED, Block TJ, Stub DA, et al. Postmortem Interrogation of Cardiac Implantable Electronic Devices. JACC: Clinical Electrophysiology. 2022, 8(3): 356-366. https://doi.org/10.1016/j.jacep.2021.10.011
  31. Olabi AG, Abdelghafar AA, Soudan B, et al. Artificial neural network driven prognosis and estimation of Lithium-Ion battery states: Current insights and future perspectives. Ain Shams Engineering Journal. 2024, 15(2): 102429. https://doi.org/10.1016/j.asej.2023.102429
  32. Katz D, Akiyama T. Pacemaker longevity: the world's longest lasting VVI pacemaker. Annals of Noninvasive Electrocardiology. 2007, 12(3): 223-226. https://doi.org/10.1111/j.1542-474X.2007.00165.x
  33. Davis J, Thibault B, Mangat I, et al. Canadian Registry of Electronic Device Outcomes (CREDO): The Abbott ICD Premature Battery Depletion Advisory, a Multicentre Cohort Study. CJC Open. 2021, 3(1): 48-53. https://doi.org/10.1016/j.cjco.2020.09.008
  34. Melman YF, Steinberg BA, Lancaster J, et al. Limitations of manufacturer-recommended remote monitoring in the St. Jude Assurity/Endurity battery recall. HeartRhythm Case Reports. 2021, 7(12): 791-794. https://doi.org/10.1016/j.hrcr.2021.09.013
  35. Sinha SK, Akinyele B, Spragg DD, et al. Managing cardiac implantable electronic device patients during a health care crisis: Practical guidance. Heart Rhythm O2. 2020, 1(3): 222-226. https://doi.org/10.1016/j.hroo.2020.05.005
  36. Neuenschwander JF, Peacock WF, Migeed M, et al. Safety and efficiency of emergency department interrogation of cardiac devices. Clinical and Experimental Emergency Medicine. 2016, 3(4): 239-244. https://doi.org/10.15441/ceem.15.118
  37. D’Angelo RN, Pickett CC. Diagnostic yield of device interrogation in the evaluation of syncope in an elderly population. International Journal of Cardiology. 2017, 236: 164-167. https://doi.org/10.1016/j.ijcard.2017.02.121
  38. Sobel RM, Donaldson PR, Dhruva N. Pacemaker-mediated tachycardia: Management by pacemaker interrogation/reprogramming in the ED. The American Journal of Emergency Medicine. 2002, 20(4): 336-339. https://doi.org/10.1053/ajem.2002.33780
  39. Kawase K, Yamagata K, Ishibashi K, et al. Leadless pacemaker interrogation interference after conversion of a left ventricular assist device. HeartRhythm Case Reports. 2023, 9(1): 25-27. https://doi.org/10.1016/j.hrcr.2022.10.005
  40. Cronin B, Birgersdotter-Green U, Essandoh MK. Perioperative Interrogation of Boston Scientific Cardiovascular Implantable Electronic Devices: A Guide for Anesthesiologists. Journal of Cardiothoracic and Vascular Anesthesia. 2019, 33(4): 1076-1089. https://doi.org/10.1053/j.jvca.2018.05.005
  41. Burgemeestre GM, Timmer SAJ. Syncope due to pacemaker failure to capture after device transition into Safety Mode. HeartRhythm Case Reports. 2022, 8(7): 482-484. https://doi.org/10.1016/j.hrcr.2022.04.008
  42. Boriani G, Bertini M, Saporito D, et al. Impact of pacemaker longevity on expected device replacement rates: Results from computer simulations based on a multicenter registry (ESSENTIAL). Clinical Cardiology. 2018, 41(9): 1185-1191. https://doi.org/10.1002/clc.23003
  43. Varma N, Braunschweig F, Burri H, et al. Remote monitoring of cardiac implantable electronic devices and disease management. Europace. 2023, 25(9). https://doi.org/10.1093/europace/euad233
  44. Alam MB, Munir MB, Rattan R, et al. Battery longevity in cardiac resynchronization therapy implantable cardioverter defibrillators. Europace. 2013, 16(2): 246-251. https://doi.org/10.1093/europace/eut301
  45. Censi F, Calcagnini G, Mattei E, et al. Estimate and reporting of longevity for cardiac implantable electronic devices: a proposal for standardized criteria. Expert Review of Medical Devices. 2021, 18(12): 1203-1208. https://doi.org/10.1080/17434440.2021.2013199
  46. Kusumoto FM, Schoenfeld MH, Wilkoff BL, et al. 2017 HRS expert consensus statement on cardiovascular implantable electronic device lead management and extraction. Heart Rhythm. 2017, 14(12): e503-e551. https://doi.org/10.1016/j.hrthm.2017.09.001
  47. Karnik AA, Helm RH, Gaskill MD, et al. High impedance alert with safety switching: An unreported hazard of hybrid pacing systems. Journal of Cardiovascular Electrophysiology. 2019, 30(7): 1102-1107. https://doi.org/10.1111/jce.13941
  48. Diamond J, Varma N, Kramer DB. Making the Most of Cardiac Device Remote Management. Circulation: Arrhythmia and Electrophysiology. 2021, 14(3). https://doi.org/10.1161/circep.120.009497
  49. Slotwiner DJ, Abraham RL, Al-Khatib SM, et al. HRS White Paper on interoperability of data from cardiac implantable electronic devices (CIEDs). Heart Rhythm. 2019, 16(9): e107-e127. https://doi.org/10.1016/j.hrthm.2019.05.002
  50. Daley C, Coupe A, Allmandinger T, et al. Clinician use of data elements from cardiovascular implantable electronic devices in clinical practice. Cardiovascular Digital Health Journal. 2023, 4(1): 29-38. https://doi.org/10.1016/j.cvdhj.2022.10.007
  51. Slotwiner DJ, Serwer GA, Allred JD, et al. 2024 HRS perspective on advancing workflows for CIED remote monitoring. Heart Rhythm O2. 2024, 5(12): 845-853. https://doi.org/10.1016/j.hroo.2024.09.012