Key result
A five-cycle median filtering algorithm provided better discrimination of sinus tachycardia and ventricular tachycardia than previously published sudden onset rate algorithms.
Why the study?
Does a five-cycle median filter algorithm improve discrimination of ventricular tachycardia from sinus tachycardia compared to sudden onset rate algorithms in patients with implantable devices?
Observational (n=50)
Does a five-cycle median filter algorithm improve discrimination of ventricular tachycardia from sinus tachycardia compared to sudden onset rate algorithms in patients with implantable devices?
A five-cycle median filtering algorithm provides superior discrimination between physiologic sinus tachycardia and pathologic ventricular tachycardia compared to traditional sudden onset rate algorithms.
Answers are grounded in this paper and cite their sources.
May improve device-based VT discrimination; leaves open prospective validation before clinical adoption.
Rate and rate variation algorithms used by implantable devices designed for management of life-threatening arrhythmias have major limitations in separating physiologic sinus tachycardia (ST) from pathologic ventricular tachycardia (VT) requiring therapy. These algorithms presently utilize criteria such as simple heart rate, stability of rate, or derivative of rate (sudden onset) which assumes a gradual onset for ST and an abrupt onset for VT. An alternative method employing median filtering was designed, tested, and compared to a previously published sudden onset rate algorithm using the same data set for analysis of performance. In 50 patients, the onset of ST during exercise and onset of VT were analysed. To accommodate occasional outlying intervals which might affect rate derived by averaging, a five-cycle median filter was used to smooth heart rate. Results from using a 'fixed-interval' or a 'percent' change in the median gave better discrimination of ST and VT than previously published 'fixed-interval' or 'percent' change algorithms. The superiority of median filtering performance was validated by statistical measures.
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Chiang et al. (1994) conducted an observational in Ventricular tachycardia and sinus tachycardia (n=50). Five-cycle median filtering algorithm vs. Previously published sudden onset rate algorithm was evaluated on Discrimination of sinus tachycardia and ventricular tachycardia. A five-cycle median filtering algorithm provided better discrimination of sinus tachycardia and ventricular tachycardia than previously published sudden onset rate algorithms.
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