An Automatic Algorithm Based on Morphological Stability During Fast Ventricular Arrhythmias Predicts Successful Antitachycardia Pacing in ICD Patients: A Multicenter Study.
Background Different types of ventricular arrhythmias (monomorphic ventricular tachycardia [VT], polymorphic VT, or ventricular fibrillation) can be detected by implantable cardiac defibrillators (ICDs) in fast VT zone. The efficacy of antitachycardia pacing (ATP) depends on the type of the treated...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 39; no. 7; pp. 633 - 642 |
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| Autores principales: | , , , , , , , , , , , , |
| Formato: | algorithm equations & formulas research tables/charts tracings Journal Article |
| Publicado: |
Wiley-Blackwell
Jul2016
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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=116618020&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 116618020 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Jul2016 vid: 39 iid: 7 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 116618020 116618020 116618020 10.1111/pace.12858 116618020 ppf: 633 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: An Automatic Algorithm Based on Morphological Stability During Fast Ventricular Arrhythmias Predicts Successful Antitachycardia Pacing in ICD Patients: A Multicenter Study. aug: au: MATÍA, ROBERTO HERNÁNDEZ ‐ MADRID, ANTONIO SÁNCHEZ ‐ HUETE, GONZALO MARTÍNEZ ‐ FERRER, JOSÉ BAUTISTA ALZUETA, JAVIER VIÑOLAS, XAVIER RUBIO, JERÓNIMO PORRES, JOSÉ MANUEL RODRÍGUEZ, ANÍBAL GARCÍA, ENRIQUE FERNÁNDEZ ‐ LOZANO, IGNACIO ÁLVAREZ, MIGUEL MORENO, JAVIER affil: Arrhythmia Unit, Cardiology Department, Ramón y Cajal Hospital, Madrid Spain sug: subj: Algorithms Cardiac Pacing, Artificial Defibrillators, Implantable Heart Ventricle Anatomy and Histology Tachycardia, Ventricular Human Electrocardiography Descriptive Statistics Data Analysis Software Odds Ratio Confidence Intervals Observational Methods Prospective Studies Retrospective Design Funding Source Fisher's Exact Test Chi Square Test ab: Background Different types of ventricular arrhythmias (monomorphic ventricular tachycardia [VT], polymorphic VT, or ventricular fibrillation) can be detected by implantable cardiac defibrillators (ICDs) in fast VT zone. The efficacy of antitachycardia pacing (ATP) depends on the type of the treated arrhythmia. We hypothesized that an automatic algorithm based on morphological affinity of ICD far-field electrograms during tachycardia can predict ATP success and the need of shock. Methods The algorithm was evaluated on ventricular arrhythmias recorded in CareLink ICD remote monitoring system (Medtronic Inc., Minneapolis, MN, USA). Patients were selected if first ATP programmed was a burst of eight pulses at 88% coupling interval and if a far-field electrogram was available. The algorithm calculated a stability coefficient (SC) for all their stored ATP-treated fast ventricular arrhythmia (VA) episodes (LC 200-300 ms), analyzing the morphology homogeneity of the last eight recorded far-field electrograms before ventricular arrhythmias detection. Results Inclusion criteria were fulfilled by 717 patients from 29 centers. Three hundred and twenty fast VA were recorded in 103 patients. A higher SC was observed in episodes terminated with the first-ATP (0.78 [0.72-0.84] vs 0.74 [0.60-0.84]; P = 0.006). These differences were especially marked among the 62 episodes of very fast VA (CL ≤250 ms) (0.77 [0.74-0.85] vs 0.64 [0.51-0.8]; P = 0.006). In the multivariate analysis, a SC > 70% was independently associated with a higher likelihood of first-ATP success (odds ratio [OR] = 2.5; [95% confidence interval (CI) = 1.4-4.5], P = 0.001) and a lower need of shock (OR = 0.37; [95% CI = 0.2-0.7], P = 0.002). Conclusion This automatic algorithm (stability coefficient) shows that ATP therapy response can be predicted in fast ventricular arrhythmias through morphology evaluation. pubtype: Academic Journal doctype: algorithm equations & formulas research tables/charts tracings Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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