Discrimination between ventricular and supraventricular tachycardia by dual chamber cardioverter defibrillators: importance of the atrial sensing function.
Although the addition of atrial sensing in dual chamber ICDs may improve the ability of the device to discriminate between supraventricular (SVT) and ventricular tachycardia (VT), atria! sensing errors may also negatively affect tachycardia classification. This prospective study evaluated the incide...
| Published in: | Pacing & Clinical Electrophysiology Vol. 24; no. 2; pp. 183 - 191 |
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| Main Authors: | , , , , |
| Format: | research Journal Article |
| Published: |
Wiley-Blackwell
Feb2001
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106086625&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106086625 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Feb2001 vid: 24 iid: 2 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106086625 2009412007 10.1046/j.1460-9592.2001.00183.x NLM11270697 106086625 ppf: 183 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Discrimination between ventricular and supraventricular tachycardia by dual chamber cardioverter defibrillators: importance of the atrial sensing function. aug: au: Israel CW Grönefeld1 G Iscolo N Stöppler C Hohnloser SH sug: subj: Defibrillators, Implantable Tachycardia, Supraventricular Diagnosis Tachycardia, Supraventricular Therapy Tachycardia, Ventricular Diagnosis Tachycardia, Ventricular Therapy Algorithms Case Control Studies Equipment Failure False Negative Results False Positive Results Female Incidence Logistic Regression Male Middle Age Prospective Studies Time Factors Human Middle Aged: 45-64 years Female Male ab: Although the addition of atrial sensing in dual chamber ICDs may improve the ability of the device to discriminate between supraventricular (SVT) and ventricular tachycardia (VT), atria! sensing errors may also negatively affect tachycardia classification. This prospective study evaluated the incidence of atrial sensing errors in a dual chamber ICD and their impact on VT/SVT discrimination. In 145 patients, a dual chamber ICD (Defender) was implanted. Analysis of 1,241 tachycardia episodes stored during a mean follow-up of 14 ± 8 months revealed atrial sensing errors in 817 (66%) episodes. Upon expert review, device-based classification was confirmed in 509 (98%) of 522 SVT episodes. No false device-based SVT classification was related to atrial sensing errors. Of 719 episodes classified as VT by the device, 645 (90%) were confirmed. There were 74 episodes of false-positive VT detection. Of these, 63 were related to atrial sensing errors: atrial undersensing in 58 (92%) and atrial oversensing in 5 (8%) episodes. Atrial sensing errors led to incorrect VT/SVT discrimination in 51 (4%) of 1,241 episodes. Only the occurrence of paroxysmal atrial fibrillation and abdominal site of device implantation showed a significant influence on false VT/SVT discrimination. Atrial sensing errors are frequently encountered in dual chamber ICDs. Due to the VT/SVT discrimination algorithm, atrial sensing errors only led to misclassification in 4% of all episodes, mainly due to atrial undersensing. No VT underdetection due to atrial oversensing occurred. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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