April 28, 2005Journal of Cardiovascular Electrophysiology
Optimal Combination of Discriminators for Differentiating Ventricular from Supraventricular Tachycardia by Dual‐Chamber Defibrillators
Key result
Programming dual-chamber ICDs with morphology only in the V=A branch and morphology or interval stability in the V<A branch achieved 99% sensitivity and 79% specificity for SVT-VT discrimination.
Why the study?
What is the optimal combination of discriminators for differentiating ventricular from supraventricular tachycardia in dual-chamber ICDs?
Population
203 patients with Photon DR dual-chamber implantable cardioverter defibrillators, providing 596 spontaneous…
Comparison
Combinations of SVT-VT discriminators using ANY… vs Comparison among different discriminator…
Design
Cohort
Authors
Discussion
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Implication
May optimize SVT-VT discrimination in dual-chamber ICDs; hypothesis-generating and leaves open prospective validation.
Study Design
Type
Observational (n=203)
Structured PICO
What is the optimal combination of discriminators for differentiating ventricular from supraventricular tachycardia in dual-chamber ICDs?
P
Population
203 patients with Photon DR dual-chamber implantable cardioverter defibrillators (ICDs), providing 596 spontaneous tachyarrhythmias
I
Intervention
Combinations of SVT-VT discriminators (morphology, sudden onset, interval stability) using ANY or ALL logic
C
Comparator
Comparison among different discriminator combinations and logic settings
O
Outcome
Sensitivity, specificity, positive predictive value, and negative predictive value for differentiating ventricular from supraventricular tachycardiasurrogate
For dual-chamber ICDs, optimal SVT-VT discrimination is achieved using morphology only in the V=A branch and morphology or interval stability (ANY logic) in the V<A branch, whereas ALL logic unacceptably reduces sensitivity.
Cite This Study
Glikson et al. (2005) conducted an observational in Ventricular and supraventricular tachycardia (n=203). Dual-chamber ICD discriminator algorithms (morphology, interval stability, sudden onset using ANY or ALL logic) vs. Alternative discriminator combinations was evaluated on Sensitivity and specificity for SVT-VT discrimination. Programming dual-chamber ICDs with morphology only in the V=A branch and morphology or interval stability in the V<A branch achieved 99% sensitivity and 79% specificity for SVT-VT discrimination.