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...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 28; no. 6; pp. 555 - 561 |
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| Autores principales: | , , , |
| Formato: | algorithm research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jun2005
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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=106389315&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106389315 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Jun2005 vid: 28 iid: 6 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106389315 2009088815 10.1111/j.1540-8159.2005.50011.x NLM15955189 106389315 ppf: 555 ppct: 6 formats: fmt: @attributes: type: P tig: 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 refInfo: holdings: @attributes: islocal: N |
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