Abstract:
:Implantable cardioverter defibrillators (ICDs) detect and defibrillate ventricular fibrillation (VF) and ventricular tachycardia (VT). Other therapies which use less energy are also available to terminate VT. Previous studies have shown that ICD rate schemes often misdiagnose VT as VF. In this study, an improved VF classification scheme was designed and tested, which employs the classic rate criteria plus paired signal concordance (PSC); PSC uniquely detects VF where VT and VF rates overlap (220-340 ms). Two signals from a bipolar pair (1 cm) recorded in a unipolar sense exhibit similar signal shape for concordant rhythms, such as sinus rhythm and VT, and disconcordance for VF. Once the rate criterion is met, PSC is measured by the peak normalized cross-correlation coefficient calculated over the depolarization. Variability, measured by a modified range, determined the contextual diagnosis over a passage. Sinus rhythm (20), VT (12), VF (22), atrial fibrillation (10), sinus rhythm with ventricular premature depolarizations (7), and polymorphic VT (4) passages were recorded from 38 patients. Rate-PSC was tested with unfiltered, digitized signals (1-500 Hz, 1,000 samples per second) and with filtered, downsampled signals (1-50 Hz, 100 samples per second). Sensitivity values, or percentage of correct VF detection, and specificity values, or detection of all other rhythms, were generated and compared with simulations of three commercial ICDs programmed to similar settings as rate-PSC and to nominal settings. The sensitivity values for rate-PSC with unfiltered and with filtered signals and for ICDs with 220 ms and with nominal settings were 100%, 100%, 48-80%, and 100%, respectively; the corresponding specificity values were 95%, 83%, 93%, and 7-13%, respectively. It was concluded that the rate-PSC scheme was able to reliably separate VF from other rhythms, even rhythms that have a variable morphology or variable rate. With the confidence of accurate VF detection, use of low-energy therapies for non-VF rhythms will increase device longevity and enhance patient comfort.
journal_name
J Electrocardioljournal_title
Journal of electrocardiologyauthors
Caswell SA,Jenkins JM,DiCarlo LAdoi
10.1016/s0022-0736(98)80060-5subject
Has Abstractpub_date
1998-01-01 00:00:00pages
131-6eissn
0022-0736issn
1532-8430journal_volume
30 Supplpub_type
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journal_title:Journal of electrocardiology
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journal_title:Journal of electrocardiology
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更新日期:2020-01-01 00:00:00
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journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/0022-0736(92)90040-7
更新日期:1992-10-01 00:00:00
abstract::Initial electrical forces emanating from interventricular septal depolarization, being directed to the right and anteriorly, normally produce an initial negative deflection or Q wave in leads I, aVL and V6 and an initial positive deflection or R wave in leads V1 and V2. The observations of hypertrophied interventricul...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
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更新日期:1981-01-01 00:00:00
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journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(84)80030-8
更新日期:1984-01-01 00:00:00
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journal_title:Journal of electrocardiology
pub_type: 杂志文章
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更新日期:2010-11-01 00:00:00
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journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(82)80033-2
更新日期:1982-01-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:1999-01-01 00:00:00
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journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(86)80017-6
更新日期:1986-04-01 00:00:00
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journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(85)80035-2
更新日期:1985-01-01 00:00:00
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journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2012.11.013
更新日期:2013-03-01 00:00:00
abstract:INTRODUCTION:The right ventricular myocardial infarction (RVMI) has traditionally been mainly related to inferior wall ST elevation myocardial infarction (STEMI). This study assessed the RVMI electrocardiographic (ECG-RVMI) signs in relationship to ECG-based STEMI localization and to the infarct related artery in patie...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2016.08.001
更新日期:2016-01-01 00:00:00
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journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/0022-0736(88)90102-1
更新日期:1988-08-01 00:00:00
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journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2016.07.021
更新日期:2016-01-01 00:00:00
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journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(85)80029-7
更新日期:1985-01-01 00:00:00
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journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2019.07.004
更新日期:2019-01-01 00:00:00
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journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(99)90032-8
更新日期:1999-01-01 00:00:00
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journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2016.07.035
更新日期:2016-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/s0022-0736(86)80006-1
更新日期:1986-01-01 00:00:00
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journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/0022-0736(89)90024-1
更新日期:1989-01-01 00:00:00
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journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2007.03.013
更新日期:2007-09-01 00:00:00
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journal_title:Journal of electrocardiology
pub_type: 杂志文章,meta分析,评审
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更新日期:2013-03-01 00:00:00
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journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
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journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(96)80124-5
更新日期:1996-04-01 00:00:00
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journal_title:Journal of electrocardiology
pub_type: 杂志文章
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更新日期:2010-11-01 00:00:00
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journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(78)80107-1
更新日期:1978-04-01 00:00:00
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journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/0022-0736(89)90003-4
更新日期:1989-10-01 00:00:00
abstract::We have developed a computer program which simulates a paced cardiac rhythm strip, graphically generating the electrocardiogram (ECG) on a color monitor. Any pacemaker, programmed as desired, dynamically interacts with a preselected intrinsic rhythm. Utilizing symbols prevalent in the pacing industry, this graphics-or...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:
更新日期:1987-10-01 00:00:00
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journal_title:Journal of electrocardiology
pub_type: 杂志文章
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更新日期:2004-10-01 00:00:00