PMID: 9535490Apr 16, 1998Paper

Comprehensive scheme for detection of ventricular fibrillation for implantable cardioverter defibrillators

Journal of Electrocardiology
S A CaswellL A DiCarlo

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,...Continue Reading

References

Sep 1, 1990·IEEE Transactions on Bio-medical Engineering·N V ThakorK Y Pan
Jul 1, 1994·Pacing and Clinical Electrophysiology : PACE·R D ThroneD Wilber
Sep 1, 1993·IEEE Transactions on Bio-medical Engineering·T R TurnerM A Cameron
Aug 12, 1993·The American Journal of Cardiology·R W Campbell, S S Furniss
Aug 1, 1996·IEEE Transactions on Bio-medical Engineering·C J Finelli

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