March 31, 2011Pacing and Clinical Electrophysiology
Implantable Cardioverter Defibrillator Electrogram Adjudication for Device Registries: Methodology and Observations from ALTITUDE
Key result
An online electrogram adjudication system demonstrated substantial interobserver agreement for dual-chamber ICDs (Kappa 0.84; 95% CI 0.71-0.91), which was greater than for single-chamber devices.
Population
2,000 patients having 5,279 shock episodes, randomly sampled from 81,081 patients on remote monitoring…
Design
Cohort
Authors
Discussion
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Member takes
Implication
Supports remote adjudication of dual-chamber ICD electrograms in research; leaves open reliability for single-chamber devices and clinical adoption.
Study Design
Type
Observational (n=2,000)
Multicenter
Yes
Structured PICO
P
Population
2,000 patients having 5,279 shock episodes, randomly sampled from 81,081 patients on remote monitoring across the United States.
I
Intervention
Online EGM adjudication system by a committee of seven electrophysiologists
O
Outcome
Interobserver and intraobserver agreement (Kappa scores) for rhythm classification
Main Result
Effect estimate: Kappa 0.84 (95% CI 0.71-0.91)
Online adjudication of ICD electrograms shows substantial interreviewer agreement, which is higher for dual-chamber than single-chamber devices.
Cite This Study
Powell et al. (2011) conducted an observational in Implantable cardioverter-defibrillator (ICD) therapies (n=2,000). Online electrogram adjudication was evaluated on Interobserver agreement for dual-chamber ICDs (Kappa 0.84, 95% CI 0.71-0.91). An online electrogram adjudication system demonstrated substantial interobserver agreement for dual-chamber ICDs (Kappa 0.84; 95% CI 0.71-0.91), which was greater than for single-chamber devices.