PMID: 8946459Nov 1, 1996Paper

Limitations of tachycardia confirmation and rate classification algorithms in a third-generation implantable cardioverter defibrillator

Pacing and Clinical Electrophysiology : PACE
B S StamblerK A Ellenbogen

Abstract

Newer ICDs provide antitachycardia (ATP) and bradycardia pacing and cardioversion and defibrillation shocks based on sensed interval criteria. The objectives of this investigation were to determine the algorithm related errors in tachycardia confirmation and rate classification that occurred in patients with a third-generation, noncommitted, tiered ICD therapy. Forty-three consecutive patients with the Guardian ATP 4210 ICD, which uses an X out of Y sensed interval counting algorithm for tachycardia detection, confirmation, and classification were studied. Surface ECGs, intracardiac electrograms, stored data logs, and sense histories were reviewed to diagnose errors due to these algorithms that resulted in delivery of inappropriate therapy or inhibition of appropriate therapy. Sixty-eight classification or confirmation algorithm errors from 7,610 tachycardia detections (< 1%) were diagnosed in 23 (53%) of 43 patients. Three types of errors not related to device or sensing lead malfunction or programming mistakes were seen. In 26 episodes, the confirmation algorithm failed to detect late tachycardia reversion of nonsustained tachyarrhythmias, on the last or next to last sensed interval, and did not inhibit ATP (n = 17) or shocks...Continue Reading

References

Feb 1, 1991·Journal of the American College of Cardiology·K J VolosinH L Waxman
May 1, 1989·Journal of the American College of Cardiology·R A WinkleT Shipman
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Citations

Apr 3, 2007·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Bruce D Lindsay
Oct 30, 1998·Pacing and Clinical Electrophysiology : PACE·E M BuysJ H Kingma
Sep 2, 1998·Pacing and Clinical Electrophysiology : PACE·G M Gribbin, J M McComb

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