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Significance of missing telemetered markers in implanted cardioverter-defibrillators

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Abstract
Background: We report three patients with St Jude ICDs (St. Jude Medical, Sylmar, CA, USA) where some aspect of the marker channel was missing. Methods and Results: Two cases were caused by the simultaneous occurrence of two distinct cardiac or device events that affected the proper delivery of markers by the telemetry system. Inability of the devices to sequentially process these events resulted in incomplete transmission of telemetry data to the programmers and caused missing markers in the telemetry recordings. In the third case, sensed atrial interference resulted in a short period of atrial asynchronous pacing, which prevented the delivery of a sensed atrial marker coincident with an atrial electrogram. This atrial electrogram by virtue of its timing would have otherwise been sensed outside the atrial refractory period. Conclusion: The perplexing recordings of the three patients should not be interpreted as representing true pacemaker malfunction.
Keywords
implantable cardioverter-defibrillator, pacemaker, telemetry, atrial oversensing, atrial lead malfunction, defective pacing lead, oversensing of interference

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Chicago
Barold, S Serge, Roland Stroobandt, Frederic Van Heuverswyn, and Bengt Herweg. 2012. “Significance of Missing Telemetered Markers in Implanted Cardioverter-defibrillators.” Pace-pacing and Clinical Electrophysiology 35 (4): 409–415.
APA
Barold, S. S., Stroobandt, R., Van Heuverswyn, F., & Herweg, B. (2012). Significance of missing telemetered markers in implanted cardioverter-defibrillators. PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, 35(4), 409–415.
Vancouver
1.
Barold SS, Stroobandt R, Van Heuverswyn F, Herweg B. Significance of missing telemetered markers in implanted cardioverter-defibrillators. PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY. 2012;35(4):409–15.
MLA
Barold, S Serge, Roland Stroobandt, Frederic Van Heuverswyn, et al. “Significance of Missing Telemetered Markers in Implanted Cardioverter-defibrillators.” PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY 35.4 (2012): 409–415. Print.
@article{1976415,
  abstract     = {Background: We report three patients with St Jude ICDs (St. Jude Medical, Sylmar, CA, USA) where some aspect of the marker channel was missing. 
Methods and Results: Two cases were caused by the simultaneous occurrence of two distinct cardiac or device events that affected the proper delivery of markers by the telemetry system. Inability of the devices to sequentially process these events resulted in incomplete transmission of telemetry data to the programmers and caused missing markers in the telemetry recordings. In the third case, sensed atrial interference resulted in a short period of atrial asynchronous pacing, which prevented the delivery of a sensed atrial marker coincident with an atrial electrogram. This atrial electrogram by virtue of its timing would have otherwise been sensed outside the atrial refractory period. 
Conclusion: The perplexing recordings of the three patients should not be interpreted as representing true pacemaker malfunction.},
  author       = {Barold, S Serge and Stroobandt, Roland and Van Heuverswyn, Frederic and Herweg, Bengt},
  issn         = {0147-8389},
  journal      = {PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY},
  keywords     = {implantable cardioverter-defibrillator,pacemaker,telemetry,atrial oversensing,atrial lead malfunction,defective pacing lead,oversensing of interference},
  language     = {eng},
  number       = {4},
  pages        = {409--415},
  title        = {Significance of missing telemetered markers in implanted cardioverter-defibrillators},
  url          = {http://dx.doi.org/10.1111/j.1540-8159.2011.03323.x},
  volume       = {35},
  year         = {2012},
}

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