Discrimination of sinus rhythm, atrial flutter, and atrial fibrillation using bipolar endocardial signals.
Introduction: Analysis of endocardial signals obtained from an electrode located in the right atrium as realized in newly designed dual chamber, implantable cardioverter defibrillators might be used to provide additional therapeutic options, such as overdrive pacing or low-energy atrial cardioversio...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 9; no. 7; pp. 689 - 696 |
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| Autores principales: | , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Wiley-Blackwell
Jul1998
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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=106084369&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106084369 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Jul1998 vid: 9 iid: 7 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106084369 2009404514 10.1111/j.1540-8167.1998.tb00955.x NLM9684716 106084369 ppf: 689 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Discrimination of sinus rhythm, atrial flutter, and atrial fibrillation using bipolar endocardial signals. aug: au: Jung J Hohenberg G Heisel A Strauss D Schieffer H Fries R sug: subj: Atrial Fibrillation Diagnosis Atrial Flutter Diagnosis Sinoatrial Node Physiopathology Algorithms Atrial Fibrillation Physiopathology Atrial Fibrillation Therapy Atrial Flutter Physiopathology Atrial Flutter Therapy Defibrillators, Implantable Diagnosis, Differential Electrophysiology Methods Endocardium Female Male Middle Age Sensitivity and Specificity Human Middle Aged: 45-64 years Female Male ab: Introduction: Analysis of endocardial signals obtained from an electrode located in the right atrium as realized in newly designed dual chamber, implantable cardioverter defibrillators might be used to provide additional therapeutic options, such as overdrive pacing or low-energy atrial cardioversion for the treatment of concomitant atrial flutter (AFL) or atrial fibrillation (AF). Therefore, we developed a computer algorithm for discrimination of normal sinus rhythm (NSR), AFL, and AF that may lead to adequate differential therapy of atrial tachyarrhythmias in an automated mode. Methods and Results: During an electrophysiologic study, bipolar endocardial signals from the high right atrium were obtained in 28 patients during sustained AFL or AF and after restoration of NSR. A total of 286 data segments of 5-second duration were recorded (NSR: 96, AFL: 86, AF: 104). Mean atrial cycle length (MCL), standard deviation of mean atrial cycle length (SDCL), and index of irregularity (IR). defined as the ratio between MCL and SDCL, were calculated for each data segment. A cutoff of 315 msec for MCL allowed discrimination of NSR from atrial tachyarrhythmias with 100% sensitivity and specificity. For discrimination of AF from AFI- by using SDCL, a cutoff value of 11.5 msec led to a sensitivity of 99% and a specificity of 90%. Best discrimination of AF from AFL was found for the criterion IR > 7.5%, resulting in a sensitivity of 100% with a specificity of 95% for AF detection. Conclusion: The investigated algorithm provides discrimination of NSR, AFL, and AF with high sensitivity and specificity. Incorporation of this algorithm in an implantable automated antitachycardia device may lead to adequate differential therapy in patients suffering from spontaneous episodes of AF and AFL. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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