Pacemakers system analysis

Olson WH, Goldreyer BA, Goldreyer BN, Computer-generated diagnostic diagrams for pacemaker rhythm analysis and pacing system evaluation, J. Electrocardiol 1987 1 376-387. 

Sweeesy MW, Erickson SL, Grago JA, et al.. Analysis of the effectiveness of in-office and transtelephonic follow-up in terms of pacemaker system complications, PACE 1994 17 2001-2003. 

The EGG is one of the oldest, instrument-bound measurements in medicine. It has faithfully followed the progression of instrumentation technology. Its most recent evolutionary step, to the microprocessor-based system, has allowed patients to wear their computer monitor or provided an enhanced, high-resolution EGG which has opened new vistas of EGG analysis and interpretation. The intracardiac EGG also forms the basis of modern diagnostic EP studies and therapeutic devices, such as the pacemaker and implantable defibrillator. 

There are no prospective studies that compare cure rates for antibiotic treatment alone vs antibiotic therapy combined with CIED system removal. However, the high rate of uncontrolled or relapsing bacteremia, even after prolonged medical therapy, makes removal of the entire CIED system optimal. In one recent retrospective case analysis [11] that included patients with an infected pacemaker or ICD, infection relapse was strongly associated with failure to completely remove all hardware. This case series included 123 patients, 119 (97%) of whom had transvenous implanted leads. Only one (0.86%) of 117 patients who underwent removal of their entire system had infection relapse. In contrast, three of six (50%, P = 0.003) without complete hardware removal suffered relapse. The only patient who had hardware removal and still had infection relapse had a new generator implanted in an old pocket site. All other patients had new devices placed at different sites at... 

Santamour, B., Aiming for Perfection, Quality Care, Vol. 22, No, 34,2009, pp. 13-16. Santel, C., Trautmann, C., Liu, W., The Integration of a Formal Safety Analysis into the Software Engineering Process An Example from the Pacemaker Industry, Proceedings of the Symposium on the Engineering of Computer-Based Medical Systems, 1988, pp. 152-154. 

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