Mechanisms of Undersensing by a Noise Detection Algorithm That Utilizes Far‐Field Electrograms With Near‐Field Bandpass Filtering

Abstract

The SecureSense algorithm can withhold appropriate therapies for ventricular arrhythmias due to design and programming limitations. Electrophysiologists should have a thorough understanding of the SecureSense algorithm before routinely programming it and understand the implications for ventricular arrhythmia misclassification.

Electrogram morphology discriminators in implantable cardioverter defibrillators: A comparative evaluation

“…Alternatively, one may consider reducing the range of the Wavelet EGM source to improve the signal resolution. Above all, this raises the question of the need to test systematically the FF detection at implant, as suggested by others to improve the accuracy of noise detection algorithms that rely on this EGM source 11 . Regarding the question of optimizing the % match threshold, our results indicate that the Abbott and Medtronic nominal thresholds are similar or close to the optimal calculated thresholds.…”

Towards eradication of inappropriate therapies for ICD lead failure by combining comprehensive remote monitoring and lead noise alerts

“…As a result, neither the Medtronic Lead Noise Detection ™ nor the Abbott “ RV lead noise ” alert were reached. This is important since these alerts may inhibit therapy, a feature that can have adverse consequences …”

Novel ventricular tachyarrhythmia detection enhancement detects undertreated life-threatening arrhythmias

“…As such, programming guidelines recommends faster detection rate cutoffs and longer detection times to reduce avoidable HV therapy. However, multiple reports have revealed that generic compliance with guideline directed ICD programming recommendations, with or without undersensing, may lead to delayed or in some instances even withholding delivery of the HV therapy [13][14][15]23 . Moreover, post-mortem studies suggest that mortality in ICD implanted patients can be due to undertreated ventricular tachyarrhythmias 13,18,24,25 .…”