Electrogram configuration and detection of supraventricular tachycardias by a morphology discrimination algorithm in single chamber ICDs.

BACKGROUND: Inappropriate ICD therapy for supraventricular tachycardia (SVT) remains a significant problem. A morphology-based algorithm (Wavelet) compares baseline and tachycardia electrograms (EGM). For this analysis different EGM sources can be programmed. This study evaluates the performance of...

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Publicado en:Pacing & Clinical Electrophysiology Vol. 28; no. 6; pp. 555 - 561
Autores principales: Lüthje L, Vollmann D, Rosenfeld M, Unterberg-Buchwald C
Formato: algorithm research tables/charts Journal Article
Publicado: Wiley-Blackwell Jun2005
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2005
      vid: 28
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Electrogram configuration and detection of supraventricular tachycardias by a morphology discrimination algorithm in single chamber ICDs.
      aug:
        au:
          Lüthje L
          Vollmann D
          Rosenfeld M
          Unterberg-Buchwald C
      sug:
        subj:
          Algorithms
          Defibrillators, Implantable Equipment and Supplies
          Tachycardia, Supraventricular Diagnosis
          Funding Source
          Adult
          Aged
          Aged, 80 and Over
          Data Analysis, Statistical
          Descriptive Statistics
          Female
          Germany
          Male
          Middle Age
          Prospective Studies
          Sensitivity and Specificity
          Tachycardia, Supraventricular Physiopathology
          Human
          Adult: 19-44 years
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Female
          Male
      ab: BACKGROUND: Inappropriate ICD therapy for supraventricular tachycardia (SVT) remains a significant problem. A morphology-based algorithm (Wavelet) compares baseline and tachycardia electrograms (EGM). For this analysis different EGM sources can be programmed. This study evaluates the performance of Wavelet using two different EGM configurations (SVC-Can and RV-Can) for the detection of exercise-induced SVT. METHODS: Patients with a Medtronic model 7230 single chamber ICD and a dual coil lead were included. For each EGM source (SVC-Can or RV-Can), a baseline EGM template was acquired and the morphology similarity to this template (match percentage) was evaluated for 10-15 beats at different heart rates during exercise testing. The lower VT detection limit was programmed to 600 ms (therapies off). RESULTS: A total of 28 patients (66.9 +/- 4.7 years, 93% men) and 5,824 intracardiac QRS complexes were analyzed. With the RV-Can source, a consistently high similarity to the baseline EGM template was observed (< or =100 bpm: 90.90 +/- 0.56%; >100 bpm: 90.24 +/- 0.55%, P > 0.05). In contrast, SVC-Can was associated with a lower match percentage at baseline and a significant decrease at higher heart rates (< or =100 bpm: 77.91 +/- 2.65%; >100 bpm: 59.05 +/- 5.65%, P < 0.005). Accordingly, the specificity for appropriate detection of exercise-induced SVT was higher with RV-Can (21/21 episodes) than with SVC-Can (8/18 episodes, specificity 100% vs 44%; P < 0.0001). CONCLUSION: The RV-Can configuration appears to be superior to SVC-Can as EGM source for appropriate SVT detection with the Wavelet algorithm.
      pubtype: Academic Journal
      doctype:
        algorithm
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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