Combined use of morphology discrimination, sudden onset, and stability as discriminating algorithms in single chamber cardioverter defibrillators

被引:27
作者
Boriani, G
Occhetta, E
Pistis, G
Menozzi, C
Jorfida, M
Sermasi, S
Pagani, M
Gasparini, G
Musso, G
Dall'Acqua, A
Biffi, M
Branzi, A
机构
[1] Univ Bologna, Inst Cardiol, Div Cardiol, I-40138 Bologna, Italy
[2] St Jude Med Italia & MORAL Study Grp, Bologna, Italy
来源
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY | 2002年 / 25卷 / 09期
关键词
atrial fibrillation; implantable cardioverter defibrillators; detection; supraventricular tachycardia; ventricular tachyarrhythmias;
D O I
10.1046/j.1460-9592.2002.01357.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Morphology Discrimination (MD) is a rhythm discriminator based on QRS morphology analysis that can be combined with other discriminators like Stability, with or without Sinus Interval History (SIH) and Sudden Onset. Thirty-five patients implanted with a St. Jude Medical single chamber ICD were evaluated during exercise testing, during induced AF, and during follow-up for 14 +/- 5 months. At exercise testing (60 episodes detected) MD had a specificity (SP) of 96.7% and Sudden Onset a SP of 91.7%; during induced AF (25 episodes) both MD and Stability had a SP of 96.0%. The diagnostic performance on spontaneous arrhythmias was as follows:for ventricular tachycardia (126 episodes) a sensitivity (SE) of 94.4% for MD, 92.1% for Sudden Onset, 89.7% for Stability without SIH and 79.4% for Stability + SIH, for sinus tachycardia (44 episodes) a SP of 86.4% for MD, 97.7% for Sudden Onset, 2.3% for Stability and of 95.5% for Stability + SIH. For AF (165 cases) a SP of 67.9% for MD, 69,1% for Stability and 90.3% for Stability + SIH, 44.8% for Sudden Onset. Use of MD alone provided a SE of 94.4% and a SP of 71.4% for spontaneous arrhythmias and combined use of the discriminators in a "2 of 3 " diagnostic logic implied a SP of 90.9% with maintenance of 96.0% of SE. In single chamber ICDs a wide range of SE/SP ratios may be obtained by use of multiple discriminators, but use of the algorithm in a 2 of 3 diagnostic logic may achieve a SP of 90.9% and a SE of 96.0%.
引用
收藏
页码:1357 / 1366
页数:10
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