Clinical evaluation of morphology discrimination: an algorithm for rhythm discrimination in cardioverter defibrillators.
The aim of this study was to test the new morphology discrimination diagnostic algorithm for ICDs that differentiates supraventricular tachycardias (SVTs) from VTs by analysis of ventricular depolarization complexes morphology. Twenty-five patients implanted with a St. Jude Ventritex single chamber...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 24; no. 6; pp. 994 - 1002 |
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| Autores principales: | , , , , |
| Formato: | research Journal Article |
| Publicado: |
Wiley-Blackwell
Jun2001
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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=106086853&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106086853 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Jun2001 vid: 24 iid: 6 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106086853 2009412750 10.1046/j.1460-9592.2001.00994.x NLM11449597 106086853 ppf: 994 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Clinical evaluation of morphology discrimination: an algorithm for rhythm discrimination in cardioverter defibrillators. aug: au: Boriani G Biffi M Frabetti L Lattuca JJ Branzi A sug: subj: Algorithms Defibrillators, Implantable Tachycardia Diagnosis Tachycardia Therapy Adult Aged Female Male Middle Age Patient Discharge Prospective Studies Reproducibility of Results Sensitivity and Specificity Tachycardia Physiopathology Human Adult: 19-44 years Aged: 65+ years Middle Aged: 45-64 years Female Male ab: The aim of this study was to test the new morphology discrimination diagnostic algorithm for ICDs that differentiates supraventricular tachycardias (SVTs) from VTs by analysis of ventricular depolarization complexes morphology. Twenty-five patients implanted with a St. Jude Ventritex single chamber ICD were studied during electrophysiological evaluation at predischarge and were followed for 7 ± 4 months. Sensitivity and specificity for VT detection and overall diagnostic accuracy of the morphology discrimination algorithm were calculated on 326 detected events. At electrophysiological evaluation, the algorithm was tested during 67 episodes of right atrial pacing, during 119 episodes of BV pacing (at basal interventricular septum and HV apex) and during 27 episodes of sustained AF: specificity was 98%, sensitivity was 66%. and diagnostic accuracy was 80%. All episodes of AF were correctly diagnosed as SVT. Exclusion of detections related to pacing at the basal interventricular septum, resulted in a specificity of 98%. a sensitivity of 85%. and a diagnostic accuracy of 93%. During follow-up, evaluation of the morphology discrimination algorithm on 113 spontaneous episodes (31 VTs, 31 AF, 7 SVTs, and 44 sinus tachycardias) exhibited a specificity of 89%, a sensitivity of 100%, and adiagnostic accuracy of 92%. In conclusion, the morphology discrimination algorithm exhibits a high specificity in discriminating VTs from SVTs. although with a corresponding reduction in sensitivity. The preliminary experience on spontaneous episodes is promising. To correct for the reduction in sensitivity, it is advisable to use this algorithm in parallel with other algorithms for rhythm discrimination (sudden onset, stability) coupled with extended high rate. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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