Limitations of tachycardia confirmation and rate classification algorithms in a third-generation implantable cardioverter defibrillator.
Newer ICDs provide antitachycardia (ATP) and bradycardia pacing and cardioversion and defibrillation shocks based on sensed interval criteria. The objectives of this investigation were to determine the algorithm related errors in tachycardia confirmation and rate classification that occurred in pati...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 19; no. 11; pp. 1618 - 1629 |
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| Autores principales: | , , |
| Formato: | Journal Article |
| Publicado: |
Wiley-Blackwell
Nov1996
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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=106039450&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106039450 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Nov1996 vid: 19 iid: 11 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106039450 2009416384 NLM8946459 106039450 ppf: 1618 ppct: 11 formats: fmt: @attributes: type: P tig: atl: Limitations of tachycardia confirmation and rate classification algorithms in a third-generation implantable cardioverter defibrillator. aug: au: Stambler BS Wood MA Ellenbogen KA sug: ab: Newer ICDs provide antitachycardia (ATP) and bradycardia pacing and cardioversion and defibrillation shocks based on sensed interval criteria. The objectives of this investigation were to determine the algorithm related errors in tachycardia confirmation and rate classification that occurred in patients with a third-generation, noncommitted, tiered ICD therapy. Forty-three consecutive patients with the Guardian ATP 4210 ICD, which uses an X out of Y sensed interval counting algorithm for tachycardia detection, confirmation, and classification were studied. Surface ECGs, intracardiac electrograms, stored data logs, and sense histories were reviewed to diagnose errors due to these algorithms that resulted in delivery of inappropriate therapy or inhibition of appropriate therapy. Sixty-eight classification or confirmation algorithm errors from 7,610 tachycardia detections (< 1%) were diagnosed in 23 (53%) of 43 patients. Three types of errors not related to device or sensing lead malfunction or programming mistakes were seen. In 26 episodes, the confirmation algorithm failed to detect late tachycardia reversion of nonsustained tachyarrhythmias, on the last or next to last sensed interval, and did not inhibit ATP (n = 17) or shocks (n = 9). In 28 episodes, inaccurate classification of tachycardia rate resulted in inappropriate ATP (n = 23) or shock (n = 5) therapy. In 14 episodes, the posttherapy reconfirmation algorithm produced inhibition of VVI pacing and prolonged asystole following shock therapy. These errors in tachycardia confirmation and rate classification were due to the inherent limitations of the X out of Y counting algorithm. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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