April 25, 2020Journal of Cardiovascular Electrophysiology
Electrogram morphology discriminators in implantable cardioverter defibrillators: A comparative evaluation
Why the study?
ICD electrogram morphology algorithms are recommended as standalone discriminators, but proprietary algorithms differ in design and nominal programming.
Do different proprietary morphology algorithms in implantable cardioverter defibrillators differ in their ability to discriminate ventricular from supraventricular tachycardia?
Population
534 VT and SVT episodes from dual- and triple-chamber ICDs across nine European centers
Comparison
Three different algorithms (Abbott, Boston Scientific, and Medtronic) with nominal vs advanced programming
Design
Multicenter comparative evaluation
Authors
Discussion
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Member takes
Implication
Algorithm differences in SVT-VT discrimination advise caution with nominal settings; leaves open whether advanced programming improves real-world outcomes.
Structured PICO
Do different proprietary morphology algorithms in implantable cardioverter defibrillators differ in their ability to discriminate ventricular from supraventricular tachycardia?
P
Population
534 episodes of ventricular tachycardia (VT) and supraventricular tachycardia (SVT) collected from Abbott, Boston Scientific, and Medtronic dual- and triple-chamber implantable cardioverter defibrillators (ICDs) across nine European centers.
I
Intervention
Abbott Far Field MD, Boston Scientific RhythmID, and Medtronic Wavelet morphology algorithms (nominal versus advanced programming).
C
Comparator
Atrioventricular comparison (reference standard for classifying VT vs SVT).
O
Outcome
Ability to discriminate between ventricular tachycardia (VT) and supraventricular tachycardia (SVT) measured by area under the curve (AUC), sensitivity, and specificity.surrogate
Proprietary morphology discriminators in ICDs exhibit significant differences in SVT discrimination, highlighting the potential need for device-specific programming optimization.
Cite This Study
Frontera et al. (2020) studied this question.