Underdetection of ventricular tachycardia by algorithms to enhance specificity in a tiered-therapy cardioverter-defibrillator

Swerdlow, Charles D.; Ahern, Thomas; Chen, Peng Sheng; Hwang, Chun; Gang, Eli S.; Mandel, William J.; Kass, Robert M.; Peter, C. Thomas

doi:10.1016/0735-1097(94)90298-4

Cited by 114 publications

(55 citation statements)

References 22 publications

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“…Swerdlow et al [11] showed that the sudden onset failed to detect 0.5% of spontaneous VT episodes. Other limitation of the onset criterion is the inability to distinguish paroxysmal ATs with sudden onset.…”

Section: Discussionmentioning

confidence: 99%

Postpacing Interval During Right Ventricular Overdrive Pacing to Discriminate Supraventricular from Ventricular tachycardia

Yalın

Gölcük

Karaayvaz

et al. 2017

Journal of Atrial Fibrillation

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Section: Discussionmentioning

confidence: 99%

Postpacing Interval During Right Ventricular Overdrive Pacing to Discriminate Supraventricular from Ventricular tachycardia

Yalın

Gölcük

Karaayvaz

et al. 2017

Journal of Atrial Fibrillation

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“…19 Programming the AICDs to a higher detection rate reduces the sensing and misinterpretation of atrial arrhythmias as ventricular arrhythmias. 13 But, this could lead to potential under detection of relatively slow monomorphic VTs, polymorphic ventricular arrhythmias or ventricular fi brillation due to intermittent undersensing. 13 Use of dual-chamber devices have shown to decrease the odds of inappropriate detection when compared to single-chamber detection.…”

Section: Minimizing Inappropriate Shocksmentioning

confidence: 99%

“…There is a theoretical risk of under detection of true malignant ventricular arrhythmias, but current data suggest that such under detection is infrequent. 12,13 The effectiveness of such discriminator is reduced when atrium fi res at rates more than 170/min.…”

Section: Minimizing Inappropriate Shocksmentioning

confidence: 99%

Preface to the fourth issue of Journal of Cardiovascular Disease Research

Dai

2010

Journal of Cardiovascular Disease Research

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Introduction: Automated implantable cardioverter defi brillator (AICD) interventions have the potential to be proarrhythmogenic. This is related to suboptimal programming and technical limitations of the device. We sought to categorize the stored events in Boston Scientifi c Latitude remote monitoring system to appropriate and inappropriate shocks and identify the proarrhythmic event. Methods: Currently patients with an AICD are monitored and stored remotely. We reviewed the Boston Scientifi c Latitude database for stored events and categorized them. Shocks delivered for deleterious arrhythmias (ventricular fi brillation) were considered appropriate. Shocks delivered for relatively benign arrhythmias (ex-sinus tachycardia treated with anti-tachycardic pacing) were considered inappropriate. Worsening of baseline arrhythmia secondary to implantable cardioverter-defi brillator treatment is considered proarrhythmic (ex-sustained ventricular tachycardia [VT] treated with shock resulting in ventricular fi brillation). Results: Of the 3049 stored events, 380 shock events were identifi ed. Among them, 132 events were induced during AICD implantation for testing purposes and thus excluded. One hundred and eighty were considered appropriate as the device shocked them out of sustained VT. Nine events were considered appropriate and proarrhythmic. Fifty-fi ve were considered inappropriate as the shock was delivered for supraventricular arrhythmia. Four events were considered inappropriate and proarrhythmic as the AICD shocked the clinically inappropriate rhythm resulting in worsening of arrhythmia. Conclusion: We noted 13 proarrhythmic events. Most of them are due to inadvertent recognition of supraventricular arrhythmia and delivering of therapies. Proarrhythmogenicity can be minimized by careful programming of the AICD.

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“…Patient-related factors include rate-dependent bundle branch block during SVT and exercise-induced myopotentials in sinus tachycardia [24]. Algorithmrelated factors include misalignment of the sinus template with the tachycardia electrocardiogram, clipping of high-amplitude electrocardiograms, electrocardiogram changes during lead maturation, and shock-induced electrocardiogram changes [25].…”

Section: Single-chamber Svt-vt Discriminatorsmentioning

confidence: 99%

Implanted Devices and Atrial Fibrillation

Guerra¹,

Brambatti²,

Matassini³

et al. 2012

Current Issues and Recent Advances in Pacemaker Therapy

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Underdetection of ventricular tachycardia by algorithms to enhance specificity in a tiered-therapy cardioverter-defibrillator

Abstract: Algorithms to enhance specificity cause underdetection of ventricular tachycardia in a significant minority of patients with tiered-therapy cardioverter-defibrillators. Optimal programming can minimize underdetection.

Cited by 114 publications

References 22 publications

Postpacing Interval During Right Ventricular Overdrive Pacing to Discriminate Supraventricular from Ventricular tachycardia

Postpacing Interval During Right Ventricular Overdrive Pacing to Discriminate Supraventricular from Ventricular tachycardia

Preface to the fourth issue of Journal of Cardiovascular Disease Research

Implanted Devices and Atrial Fibrillation

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