Observations of pacemaker pulses in high-bandwidth electrocardiograms and Dower-estimated vectorcardiograms

Jonathon Koenig, Alan V. Sahakian, Anthony Ricke, Steven Swiryn

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: Electronic pacemaker pulses are poorly reproduced in computerized electrocardiogram (ECG) tracings, impairing both automated and human interpretation. In this study, a high-bandwidth system is used to examine ECG and vectorcardiogram characteristics of pacemaker pulses. Methods: In 69 subjects with artificial pacemakers, electrocardiograms were recorded at 75 000 samples per second with a high-bandwidth ECG system (GE Healthcare, Milwaukee, WI). Vectorcardiograms, as estimated with the Dower transform, were examined. Results: Pulse loops in the vectorcardiogram consisted of distinct discharge and recharge waves, with an angle difference of 174° ± 10° (mean ± SD) in 3 dimensions. Atrial pulses were on average oriented anteriorly, superiorly, and to the left; right ventricular pulses were oriented posteriorly, superiorly, and to the right; and left ventricular pulses were oriented posteriorly, inferiorly, and to the right. Other details of pacemaker pulses could be readily observed. Conclusions: The high-bandwidth ECG has the potential to improve interpretation of paced rhythms in computerized ECGs.

Original languageEnglish (US)
Pages (from-to)275-281
Number of pages7
JournalJournal of Electrocardiology
Issue number2
StatePublished - Mar 2011

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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