A New Algorithm to Reduce Inappropriate Therapy in the S-ICD System.
A New Algorithm to Reduce Inappropriate Therapy Introduction The subcutaneous ICD system (S-ICD) has been shown to be a safe and effective treatment for patients at risk for sudden cardiac death. This device reliably detects ventricular tachyarrhythmias with a low incidence of inappropriate shocks f...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 26; no. 4; pp. 417 - 424 |
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| Autores principales: | , , , , , , , , |
| Formato: | algorithm research tables/charts tracings Journal Article |
| Publicado: |
Wiley-Blackwell
Apr2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103788156&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103788156 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Apr2015 vid: 26 iid: 4 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 103788156 102043585 10.1111/jce.12612 NLM25581303 103788156 ppf: 417 ppct: 7 formats: fmt: @attributes: type: P tig: atl: A New Algorithm to Reduce Inappropriate Therapy in the S-ICD System. aug: au: Brisben, Amy J. Burke, Martin C. Knight, Bradley P. Hahn, Stephen J. Herrmann, Keith L. Allavatam, Venugopal Mahajan, Deepa Sanghera, Rick Gold, Michael R. affil: Boston Scientific Corporation sug: subj: Death, Sudden, Cardiac Prevention and Control Defibrillators, Implantable Adverse Effects Algorithms Equipment Failure Arrhythmia, Ventricular Diagnosis Arrhythmia, Ventricular Therapy Human Descriptive Statistics Electrocardiography QRS Complex Confidence Intervals Paired T-Tests Logistic Regression Chi Square Test Simulations ab: A New Algorithm to Reduce Inappropriate Therapy Introduction The subcutaneous ICD system (S-ICD) has been shown to be a safe and effective treatment for patients at risk for sudden cardiac death. This device reliably detects ventricular tachyarrhythmias with a low incidence of inappropriate shocks for supraventricular arrhythmias. However, T-wave oversensing (TWOS) is more common with the S-ICD compared with transvenous systems. We developed a novel discrimination algorithm to reduce TWOS without compromising tachyarrhythmia discrimination. Methods and Results The algorithm was developed using a database of recorded episodes, including 244 appropriate therapies for ventricular arrhythmias and 133 episodes with an inappropriate detection due to TWOS, and using a computer model that simulates the S-ICD system. An independent set of data of 161 TWOS episodes, 137 ventricular and 328 supraventricular episodes, was used to validate the algorithm on actual device hardware. The S-ICD performance with the new algorithm was compared with the S-ICD without the new algorithm. Development results showed a decrease in inappropriate charge due to TWOS by 30.7 ± 18%. All ventricular arrhythmias were appropriately detected and the time to appropriate charge initiation was not increased. System validation showed that the new algorithm avoided an inappropriate charge due to TWOS by 39.8 ± 11.4%. No decrease in ventricular arrhythmia sensitivity and no significant change in supraventricular specificity were observed. Conclusions A new algorithm that uses correlation of the existing complex to previous complexes reduced TWOS episodes by approximately 40%. The algorithm has potential for a clinically meaningful decrease in inappropriate shocks. pubtype: Academic Journal doctype: algorithm research tables/charts tracings Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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