Europace Advance Access originally published online on November 14, 2006
Europace 2006 8(12):1057-1061; doi:10.1093/europace/eul119
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ICD
Performance of a new single-chamber ICD algorithm: discrimination of supraventricular and ventricular tachycardia based on vector timing and correlation
1 Deborah Heart and Lung Center, 200 Trenton Road, Browns Mills, NJ 08018, USA; 2 John Muir/Mt. Diablo Health Systems, Walnut Creek, CA, USA; 3 Baptist Medical Center, Jacksonville, FL, USA; 4 Hillcrest Medical Center, Tulsa, OK, USA; 5 Guidant Corporation, St Paul, MN, USA
Aims Interval- and morphology-based algorithms have been used in modern implantable cardioverter defibrillators (ICDs) to discriminate supraventricular tachycardia (SVT) from other rhythms. A newly developed ICD discrimination algorithm, Rhythm IDTM (Guidant Corporation, St Paul, MN, USA), uses both interval-based metrics and an electrogram vector timing and correlation (VTC) algorithm in a dual-chamber ICD. In a single-chamber ICD, Rhythm ID contains only the VTC component. This study conducted a retrospective analysis of the performance of Rhythm ID for the detection of induced and spontaneous rhythms in a single-chamber ICD.
Methods and results This study gathered the data from a prospective, multicentre clinical trial. Ninety-six patients were implanted with a dual-chamber ICD. For this study, each episode was analysed to determine the performance of the single-chamber ICD Rhythm ID algorithm. The mean age of the patients implanted with the device was 67±11 years. Seventy-eight patients were male. The primary cardiovascular disease was coronary artery disease and the primary tachyarrhythmia was monomorphic ventricular tachycardia (VT). The mean follow-up time was 11.4 months. A total of 369 induced and spontaneous ventricular arrhythmias was analysed. The algorithm detected 100% of ventricular arrhythmias. Four hundred and forty-two SVT episodes were analysed, including 145 induced and 297 spontaneous. The SVTs were atrial fibrillation (n=199), atrial flutter (n=135), and 1:1 SVT (n=108). The single-chamber ICD Rhythm ID algorithm successfully discriminated 403 SVT episodes and achieved a specificity of 91%.
Conclusion The single-chamber version of Rhythm ID demonstrated high specificity without compromising sensitivity.
Key Words: ICD, Ventricular tachyarrhythmia, Detection algorithm, Supraventricular arrhythmias
* Corresponding author. Tel: +1 609 893 6611. E-mail address: corbisieror{at}deborah.org
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