title: Development and validation of a novel algorithm based on the ECG magnet response for rapid identification of any unknown pacemaker.
abstract: BACKGROUND
  Pacemaker (PM) interrogation requires correct manufacturer identification. However, an unidentified PM is a frequent occurrence, requiring time-consuming steps to identify the device.
  
  
  OBJECTIVE
  The purpose of this study was to develop and validate a novel algorithm for PM manufacturer identification, using the ECG response to magnet application.
  
  
  METHODS
  Data on the magnet responses of all recent PM models (≤15 years) from the 5 major manufacturers were collected. An algorithm based on the ECG response to magnet application to identify the PM manufacturer was subsequently developed. Patients undergoing ECG during magnet application in various clinical situations were prospectively recruited in 7 centers. The algorithm was applied in the analysis of every ECG by a cardiologist blinded to PM information. A second blinded cardiologist analyzed a sample of randomly selected ECGs in order to assess the reproducibility of the results.
  
  
  RESULTS
  A total of 250 ECGs were analyzed during magnet application. The algorithm led to the correct single manufacturer choice in 242 ECGs (96.8%), whereas 7 (2.8%) could only be narrowed to either 1 of 2 manufacturer possibilities. Only 2 (0.4%) incorrect manufacturer identifications occurred. The algorithm identified Medtronic and Sorin Group PMs with 100% sensitivity and specificity, Biotronik PMs with 100% sensitivity and 99.5% specificity, and St. Jude and Boston Scientific PMs with 92% sensitivity and 100% specificity. The results were reproducible between the 2 blinded cardiologists with 92% concordant findings.
  
  
  CONCLUSIONS
  Unknown PM manufacturers can be accurately identified by analyzing the ECG magnet response using this newly developed algorithm.
authors.affiliation: Department of Cardiology, Pasteur University Hospital, Nice, France. Electronic address: fabiensquara@gmail.com.
authors.forename: Fabien
authors.initials: F
authors.lastname: Squara
authors.affiliation: Electrophysiology Section, Cardiovascular division, Hospital of the University of Pennsylvania, Philadelphia.
authors.forename: William W
authors.initials: WW
authors.lastname: Chik
authors.affiliation: Electrophysiology Section, Cardiovascular division, Hospital of the University of Pennsylvania, Philadelphia.
authors.forename: Daniel
authors.initials: D
authors.lastname: Benhayon
authors.affiliation: Electrophysiology Section, Cardiovascular division, Hospital of the University of Pennsylvania, Philadelphia.
authors.forename: Shingo
authors.initials: S
authors.lastname: Maeda
authors.affiliation: Service de Cardiologie, Centre Hospitalier Princesse Grace, Avenue Pasteur, Monaco.
authors.forename: Decebal Gabriel
authors.initials: DG
authors.lastname: Latcu
authors.affiliation: Department of Cardiology, Georges Pompidou University Hospital, Paris, France.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Lacaze-Gadonneix
authors.affiliation: Service de Cardiologie, Centre Hospitalier Pierre Nouveau, Cannes, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Tibi
authors.affiliation: Clinique Ambroise Paré, Neuily sur Seine, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Thomas
authors.affiliation: Electrophysiology Section, Cardiovascular division, Hospital of the University of Pennsylvania, Philadelphia.
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Cooper
authors.affiliation: Unité de Rythmologie, Institut de Cardiologie, GHU Pitié-Salpêtrière, Paris, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Duthoit
mesh_terms: D000465:Algorithms; D001145:Arrhythmias, Cardiac / Q000503:physiopathology / Q000628:therapy*; D004562:Electrocardiography / Q000295:instrumentation*; D005500:Follow-Up Studies; D006801:Humans; D059346:Magnets; D010138:Pacemaker, Artificial; D012372:ROC Curve; D015203:Reproducibility of Results
keywords: Electrocardiography; Magnet; Manufacturer; Pacemaker