Automatic and efficient r wave discrimination in the right atrium using a two-state hidden markov model.
Introduction: Discrimination of Car-field R waves from atrial events in atrial electrograms (EGMs) is problematic in present implantable pacing systems. Adjustments of atrial refractory periods and sensitivity settings are the only options, and they will not provide optimal performance in many patie...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 10; no. 3; pp. 343 - 351 |
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| Autores principales: | , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Wiley-Blackwell
Mar1999
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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=106084304&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106084304 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Mar1999 vid: 10 iid: 3 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106084304 2009404356 10.1111/j.1540-8167.1999.tb00681.x NLM10210496 106084304 ppf: 343 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Automatic and efficient r wave discrimination in the right atrium using a two-state hidden markov model. aug: au: Sun W Combs W Panken E Fotuhi P Stangl K Baumann G Theres H sug: subj: Cardiovascular System Physiology Probability Tachycardia, Supraventricular Diagnosis Tachycardia, Ventricular Diagnosis Adolescence Adult Aged Aged, 80 and Over Cardiac Pacing, Artificial Diagnosis, Differential Electrophysiology Methods Female Heart Rate Heart Ventricle Physiopathology Male Middle Age Predictive Value of Tests Reproducibility of Results Tachycardia, Supraventricular Physiopathology Tachycardia, Supraventricular Therapy Tachycardia, Ventricular Physiopathology Tachycardia, Ventricular Therapy Human Adolescent: 13-18 years Adult: 19-44 years Aged: 65+ years Aged, 80 & over Middle Aged: 45-64 years Female Male ab: Introduction: Discrimination of Car-field R waves from atrial events in atrial electrograms (EGMs) is problematic in present implantable pacing systems. Adjustments of atrial refractory periods and sensitivity settings are the only options, and they will not provide optimal performance in many patients. The reliable detection or rejection of R waves in atrial EGMs would avoid problems of atrial undersensing or oversensing, thus benefiting DOD patients by providing more reliable and specific atrial arrhythmia detection. In addition, detection of far-field R waves could allow a measurement of AV conduction time in AAI and aid in discrimination of supraventricular tachyarrhythmia from ventricular tachyarrhythmia. Methods and Results: Both atrial and ventricular unipolar EGMs were collected from 25 patients undergoing pacemaker implant or replacement. An average of 141 seconds of intrinsic or VVI paced EGMs was recorded and post analyzed. A new two-state hidden Markov model (HMM) was developed specifically for far-field R wave and P wave discrimination in the atrium. The recorded patients' EGMs were analyzed using this model, and the sensitivity and positive predictivity of far-field R wave detection were evaluated. The collected atrial EGMs were visually examined and marked as the control for verification of the detection analysis. Ear-field R wave detection using this model had an overall sensitivity of 94% ± 9.4% and a positive predictivity of 98.3% ± 4.4%; and the far-field R wave rejection using the same model had a sensitivity and a positive predictivity of 98.8% ± 3.8% and 99.1% ± 1.7%, respectively. Conclusion: Ear-field R wave detection in the right atrium by the two-state HMM is reliable and accurate, and can significantly improve atrial arrhythmia management for patients. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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