Morphology Discrimination in dual chamber ICDs achieved 100% sensitivity and 73.5% specificity for VT with 'any' criteria, and 98.7% sensitivity and 90.9% specificity with 'all' criteria.
Observational (n=25)
Does the Morphology Discrimination algorithm combined with Rate Branch rhythm classification improve diagnostic accuracy for ventricular tachyarrhythmias in patients with dual chamber ICDs?
The implementation of Morphology Discrimination in dual chamber ICDs with Rate Branch classification provides high sensitivity and specificity for detecting ventricular tachyarrhythmias.
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.
Boriani et al. (Wed,) conducted a observational in Patients with dual chamber implantable cardioverter defibrillators (n=25). Morphology Discrimination algorithm was evaluated on Sensitivity and specificity for ventricular tachyarrhythmias. Morphology Discrimination in dual chamber ICDs achieved 100% sensitivity and 73.5% specificity for VT with 'any' criteria, and 98.7% sensitivity and 90.9% specificity with 'all' criteria.
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