Journal article
A Pilot Study Examining the Performance of Polynomial-Modeled Ventricular Shock Electrograms for Rhythm Discrimination in Implantable Devices
Pacing and clinical electrophysiology, Vol.29(9), pp.930-939
Received March 6, 2006; revised April 28, 2006; accepted May 5, 2006.
09/2006
DOI: 10.1111/j.1540-8159.2006.00465.x
PMCID: PMC2602796
PMID: 16981915
Abstract
Background: Inappropriate shocks continue to be a problem for patients with implantable defibrillators (ICD). We evaluated the performance of polynomial-modeled ventricular electrograms (EGM) to discriminate between supraventricular tachycardia (SVT) and ventricular tachycardia (VT).
Methods: Seven sets of EGM from patients having both SVT and VT documented during a single ICD interrogation were included. The cardiac cycle was analyzed off-line in two parts, QR and RQ segments, which were modeled separately using third-order and sixth-order polynomial equations, respectively. These segments were then analyzed to determine which polynomial coefficients were most significant for rhythm discrimination.
Results: When analyzing the QR segment during arrhythmia, there were statistically significant (P < 0.05) correlations in 4 of 4 (100%) of the QR coefficients when comparing normal sinus rhythm (NSR) to SVT and 2 of 4 (50%) when comparing NSR to VT or SVT to VT. When analyzing the RQ segment during arrhythmia, there were statistically significant (P < 0.05) correlations in 4 of 7 (57%) of the RQ coefficients when comparing NSR to SVT, 5 of 7 (71%) when comparing NSR to VT, and 3 of 7 (43%) when comparing SVT to VT. Using a cutoff value of 50% change from NSR, the ratio of first-order to zero-order QR coefficient was able to completely separate VT from SVT (P = 0.03) in this series of patients.
Conclusion: Our data demonstrate the feasibility of simple polynomial equations that reproduce the depolarization and repolarization phases of human ventricular shock EGM. The ratio of first-order to zero-order QR coefficient was able to reliably discriminate between SVT and VT while reducing the polynomial model to a first-order system. The results of this pilot trial may serve as the basis for a larger prospective trial implementing a discrimination algorithm for use in low computational power implantable devices.
Details
- Title: Subtitle
- A Pilot Study Examining the Performance of Polynomial-Modeled Ventricular Shock Electrograms for Rhythm Discrimination in Implantable Devices
- Creators
- JEFFREY L WILLIAMS - Division of Cardiac Electrophysiology, University of Pittsburgh, Pittsburgh, PennsylvaniaVLADIMIR SHUSTERMAN - Division of Cardiac Electrophysiology, University of Pittsburgh, Pittsburgh, PennsylvaniaSAMIR SABA - Division of Cardiac Electrophysiology, University of Pittsburgh, Pittsburgh, Pennsylvania
- Resource Type
- Journal article
- Publication Details
- Pacing and clinical electrophysiology, Vol.29(9), pp.930-939
- Edition
- Received March 6, 2006; revised April 28, 2006; accepted May 5, 2006.
- Publisher
- Blackwell Publishing Inc
- DOI
- 10.1111/j.1540-8159.2006.00465.x
- PMID
- 16981915
- PMCID
- PMC2602796
- ISSN
- 0147-8389
- eISSN
- 1540-8159
- Number of pages
- 10
- Language
- English
- Date published
- 09/2006
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984094530802771
Metrics
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