Paroxysmal bundle branch block of supraventricular origin: a possible source of misdiagnosis in detecting ventricular tachycardia using time domain analyses of intraventricular electrograms.
Current implantable antitachycardia devices use several methods for differentiating sinus rhythm (SR) from supraventricular tachycardia (SVT) or ventricular tachycardia (VT). Those methods include sustained high rate, the rate of onset, changes in cycle length, and sudden onset. Additional methods f...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 13; no. 4; pp. 453 - 469 |
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| Autores principales: | , , , |
| Formato: | Journal Article |
| Publicado: |
Wiley-Blackwell
Apr1990
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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=106086720&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106086720 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Apr1990 vid: 13 iid: 4 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106086720 2009412359 NLM1692129 106086720 ppf: 453 ppct: 16 formats: fmt: @attributes: type: P tig: atl: Paroxysmal bundle branch block of supraventricular origin: a possible source of misdiagnosis in detecting ventricular tachycardia using time domain analyses of intraventricular electrograms. aug: au: Throne RD Dicarlo LA Jenkins JM Winston SA sug: subj: Bundle-Branch Block Diagnosis Cardiac Pacing, Artificial Tachycardia Diagnosis Tachycardia, Supraventricular Diagnosis Adolescence Adult Aged Aged, 80 and Over Bundle-Branch Block Physiopathology Electrocardiography Female Heart Rate Physiology Heart Ventricle Male Middle Age Models, Statistical Myocardial Contraction Physiology Tachycardia Physiopathology Tachycardia, Supraventricular Physiopathology Time Factors Adolescent: 13-18 years Adult: 19-44 years Aged: 65+ years Aged, 80 & over Middle Aged: 45-64 years Female Male ab: Current implantable antitachycardia devices use several methods for differentiating sinus rhythm (SR) from supraventricular tachycardia (SVT) or ventricular tachycardia (VT). Those methods include sustained high rate, the rate of onset, changes in cycle length, and sudden onset. Additional methods for detecting VT include techniques based upon ventricular electrogram morphology. The morphological approach is based on the assumption that the direction of cardiac activation, as sensed by a bipolar electrode in the ventricle, is different when the patient is in SR as compared to VT. Whether paroxysmal bundle branch block of supraventricular origin (BBB) can be differentiated from VT has not been determined. In this study, we compared the morphology of the ventricular electrogram during sinus rhythm with a normal QRS (SRNlQRS) or SVT with a normal QRS (SVTNlQRS) with the morphologies of BBB and VT in 30 patients undergoing cardiac electrophysiology studies. Changes in ventricular electrogram morphology were determined using three previously proposed time domain methods for VT detection: Correlation Waveform Analysis (CWA), Area of Difference (AD), and Amplitude Distribution Analysis (ADA). CWA, AD, and ADA distinguished VT from SRNlQRS or SVTNlQRS in 16/17 (94%), 14/17 (82%), and 12/17 (71%) patients, and BBB from SRNlQRS or SVTNlQRS in 15/15 (100%), 13/15 (87%), and 6/15 (40%) patients, respectively. However, the ranges of values during BBB using these methods overlapped with ranges of values during VT in all cases for CWA, AD, and ADA. Hence, BBB may be a source of misdiagnosis in detecting VT when these time domain methods are used for ventricular electrogram analysis. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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