Key result
Current antitachycardia pacing systems rely on rate-related parameters, but incorporating atrial sensing and hemodynamic parameters could improve diagnostic accuracy for tachycardia recognition.
This review discusses current tachycardia recognition algorithms in implantable systems and explores future strategies like atrial sensing and hemodynamic monitoring to improve diagnostic accuracy.
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Should not change device algorithms yet; leaves open need for prospective trials on atrial and hemodynamic sensing.
The detection algorithm of current antitachycardia pacing systems incorporates derivatives of heart rate as the only objective parameter used for recognition. Present pacing systems use one or more rate-related parameters: (1) rate cutoff, (2) sudden onset, (3) rate stability, and (4) sustained high rate. Recently, the development of antitachycardia systems has focused on combining the four detection criteria to form multiple recognition algorithms. Nevertheless, inability to differentiate between supraventricular and ventricular tachycardias at compatible rates remains a limitation. Incorporating atrial sensing capability, in addition to ventricular sensing capability, an alternative strategy that potentially could enhance diagnostic accuracy, is discussed. The incorporation of time and frequency analysis, arterial pressure, and stroke volume are also examined.
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Khoury et al. (1990) conducted a review in Tachycardia. Tachycardia recognition algorithms was evaluated. Current antitachycardia pacing systems rely on rate-related parameters, but incorporating atrial sensing and hemodynamic parameters could improve diagnostic accuracy for tachycardia recognition.
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