Clinical investigation of a new dual-chamber implantable cardioverter defibrillator with improved rhythm discrimination capabilities.
New ICD with Improved Rhythm Discrimination.Introduction: Despite continuing advances, inappropriate implantable cardioverter defibrillator (ICD) therapies in response to nonventricular tachyarrhythmias continue to cause patient discomfort and increased follow-up demands. Methods and Results: We inv...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 14; no. 2; pp. 144 - 150 |
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| Autores principales: | , , , |
| Formato: | clinical trial research Journal Article |
| Publicado: |
Wiley-Blackwell
Feb2003
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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=106102082&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106102082 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Feb2003 vid: 14 iid: 2 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106102082 2009472098 10.1046/j.1540-8167.2003.02285.x NLM12693494 106102082 ppf: 144 ppct: 6 formats: fmt: @attributes: type: P tig: atl: Clinical investigation of a new dual-chamber implantable cardioverter defibrillator with improved rhythm discrimination capabilities. aug: au: Bailin SJ Niebauer M Tomassoni G Leman R sug: subj: Defibrillators, Implantable Electrocardiography, Ambulatory Methods Tachycardia, Ventricular Diagnosis Tachycardia, Ventricular Therapy Ventricular Fibrillation Diagnosis Ventricular Fibrillation Therapy Adult Aged Aged, 80 and Over Clinical Trials Equipment Failure Female Male Middle Age Reproducibility of Results Sensitivity and Specificity United States Human Adult: 19-44 years Aged: 65+ years Aged, 80 & over Middle Aged: 45-64 years Female Male ab: New ICD with Improved Rhythm Discrimination.Introduction: Despite continuing advances, inappropriate implantable cardioverter defibrillator (ICD) therapies in response to nonventricular tachyarrhythmias continue to cause patient discomfort and increased follow-up demands. Methods and Results: We investigated the performance of a new dual-chamber ICD (Photon DR, St. Jude Medical), with specific attention to its arrhythmia discrimination and detection capabilities. The system uses a hierarchical approach to tachyarrhythmia classification utilizing a new AV Rate Branch feature and subsequently utilizing morphology analysis, onset, and stability criteria. The arrhythmia discrimination results from this study group were compared to historical control group data from a recent clinical investigation of single-chamber Contour MD (Morphology Discrimination) and Angstrom MD ICDs without the Rate Branch feature. Rhythm discrimination was evaluated by comparing ventricular tachycardia diagnosis sensitivity and specificity between the two groups. To determine whether the new discrimination scheme affected detection speed, median ventricular fibrillation (VF) detection and redetection times also were compared. The study group consisted of 107 patients, and the control group consisted of 161 patients. Use of the AV Rate Branch feature was associated with significant improvements in both sensitivity (100% vs 97.9%, P < 0.0001 ) and specificity (84% vs 55.7%, P = 0.0002 ) of ventricular tachycardia diagnosis. Use of the new scheme slightly but significantly accelerated VF detection times (2.8 vs 3.0 sec, P < 0.0001 ) and redetection times (1.3 vs 1.4 sec, P < 0.0001 ). Adverse events were typical for this patient population. Conclusion: Compared with earlier St. Jude Medical ICDs, the Photon DR ICD offers improved rhythm discrimination without compromising VF detection time. (J Cardiovasc Electrophysiol, Vol. 14, pp. 144-149, February 2003). pubtype: Academic Journal doctype: clinical trial research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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