Band-limited morphometric analysis of the intracardiac signal: implications for antitachycardia devices.

Inappropriate electrical therapy and power efficiency play a major role in algorithm implementation for antitachycardia devices (ATD) that capture, store, and analyze the patient electrogram as an adjunct to rate determination. Morphologically based algorithms have been demonstrated to improve speci...

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Publicado en:Pacing & Clinical Electrophysiology Vol. 20; no. 1; pp. 34 - 43
Autores principales: Morris MM, Jenkins JM, Dicarlo LA
Formato: Journal Article
Publicado: Wiley-Blackwell Jan1997
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Band-limited morphometric analysis of the intracardiac signal: implications for antitachycardia devices.
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          Morris MM
          Jenkins JM
          Dicarlo LA
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      ab: Inappropriate electrical therapy and power efficiency play a major role in algorithm implementation for antitachycardia devices (ATD) that capture, store, and analyze the patient electrogram as an adjunct to rate determination. Morphologically based algorithms have been demonstrated to improve specificity, thereby decreasing occurrences of inappropriate electrical therapy. However, morphologically based algorithms are power demanding. Optimization of power efficiency can be achieved by eliminating unnecessary algorithmic computation, but must not compromise the effectiveness of algorithms, which perform direct analysis on raw signals. Significant reductions can be achieved by reduced sampling rates, which allow for increased overall ATD efficiency via concomitant decreases in computation and data storage. This investigation determined the upper and lower bounds for filter cutoff frequency beyond which detection precision by an established morphometric method for arrhythmia classification, correlation waveform analysis (CWA), was unfavorable. Four measurement statistics were used. In ten patients with inducible VT and VF, all bipolar intraventricular electrograms were classified correctly with a minimum passband of 10-50 Hz using any of the four measurement statistics. There was 80% correct classification using all four measurement statistics with passbands having low frequency cutoffs 15 Hz and high frequency cutoffs 50 Hz. Correct classification of 90% of unipolar electrograms during NSR, VT, and VF occurred using all four measurement statistics with a passband of 1-50 Hz. There was 80% correct classification with passbands 1, 10, 15, or 20-500 Hz and 10-50 Hz. The classification of NSR, VT, and VF was most accurate on an intrapatient basis. Accuracy decreased using an interpatient rhythm classification. Optimum filter settings of 1-50 Hz and 10-50 Hz were determined for unipolar and bipolar electrograms, respectively. Sampling data at 120 Hz was found to be sufficient. Bipolar electrode configuration statistically outperfomed unipolar data. In conclusion, morphometric analysis of bipolar and unipolar intraventricular electrograms appears to be achievable using band limited data and reduced sampling rates.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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