Document Detail

Rhythm discrimination by rate branch and QRS morphology in dual chamber implantable cardioverter defibrillators.
MedLine Citation:
PMID:  12687869     Owner:  NLM     Status:  MEDLINE    
Morphology Discrimination is a discriminator based on QRS morphology analysis that has been recently implemented in dual chamber implantable cardioverter defibrillators (ICDs). Detected events are initially classified according to median atrial and ventricular rates (Rate Branch). Then, a series of discriminators (Morphology Discrimination, Stability, Sudden Onset) analyze the rhythm according to specific criteria and the number of discriminators required for VT diagnosis (i.e., requiring "any" or "all" of the specific discriminators to indicate VT). The discriminating accuracy of the algorithm was evaluated in 645 detections recorded during the follow-up of 25 patients. The overall specificity for 397 supraventricular arrhythmias was 73.5% (292/397) with the tachycardia diagnosis criteria set to "any" and 90.9% (361/397) with the tachycardia diagnosis criteria set to "all." Sensitivity for VT was 100% and 98.7% (231/234) with the tachycardia diagnosis criteria set to "any" and "all," respectively. With the tachycardia diagnosis criteria set to "any," specificity for atrial fibrillation was 88.6%, for atrial flutter 40.3%, for atrial tachycardia 0%, and for sinus tachycardia 97.0%. With the tachycardia diagnosis criteria set to "all," specificity for atrial fibrillation was 92.40%, for atrial flutter 93.5%, for atrial tachycardia 54.7%, and for sinus tachycardia 99.0%. The contribution of Morphology Discrimination was crucial to improve the specificity of the Rate Branch algorithm. The implementation of Morphology Discrimination in a dual chamber ICD with Rate Branch rhythm classification allows the attainment of high specificity and high sensitivity for ventricular tachyarrhythmias.
Giuseppe Boriani; Mauro Biffi; Alberto Dall'Acqua; Cristian Martignani; Lorenzo Frabetti; Romano Zannoli; Angelo Branzi
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  26     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2003-04-11     Completed Date:  2003-07-03     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  466-70     Citation Subset:  IM    
Institute of Cardiology, University of Bologna, Azienda Ospedaliera S. Orsola-Malpighi, Via Massarenti 9, 40138 Bologna, Italy.
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MeSH Terms
Arrhythmias, Cardiac / diagnosis*
Atrial Fibrillation / diagnosis
Atrial Flutter / diagnosis
Defibrillators, Implantable*
Sensitivity and Specificity
Tachycardia, Ventricular / diagnosis

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