Discrimination of fast ventricular tachycardia from ventricular fibrillation and slow ventricular tachycardia for an implantable pacer-cardioverter-defibrillator

W. Olson, D. Peterson, L. Ruetz, B. Gunderson, M.C. Fang-Yen
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引用次数: 7

Abstract

Implantable Pacer-Cardioverter-Defibrillators (PCD) sense ventricular electrograms from epicardial or endocardial leads with an auto-adjusting threshold and analyze a recent series of cycle lengths with algorithms to detect ventricular tachycardia (VT) and ventricular fibrillation (VF) for tiered therapies. A new algorithm to detect fast ventricular tachycardia (FVT) in a zone between VT and VF either via VT-type counting or via VF-type counting is described. Gaussian strings of cycle lengths with uniformly distributed means and standard deviations and databases of human tachyarrhythmias are analyzed. Detection algorithm sensitivity, specificity with 95% confidence intervals and the predictive value of a positive test for VF (PVP) are studied as a function of programmable defection parameters. While maintaining 100% VF sensitivity, VF specificity is increased by 20% for FVT via VF thereby safely reducing the number of painful shocks.<>
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植入式起搏器-心律转复-除颤器快速室性心动过速与室颤和慢速室性心动过速的区别
植入式起搏器-心律转复-除颤器(PCD)通过自动调节阈值来感知心外膜或心内膜导联的心室电图,并通过算法分析最近一系列的周期长度来检测室性心动过速(VT)和心室颤动(VF),以进行分层治疗。本文提出了一种通过VT型计数或VF型计数检测室性心动过速(FVT)的新算法。本文分析了周期长度均匀分布的均值和标准差高斯串和人体速性心律失常的数据库。研究了检测算法的灵敏度、95%置信区间的特异性以及VF (PVP)阳性检测的预测值与可编程缺陷参数的关系。在保持100% VF敏感性的同时,通过VF进行FVT的VF特异性提高了20%,从而安全地减少了痛苦电击的次数
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