Electrogram analysis methods reliably discriminated between sinus rhythm and VF, but including aortic pressure in the detection algorithm allowed 100% recognition of VT.
Observational (n=11)
Does electrogram analysis using ACF, PDF, and power-spectrum accurately recognize and differentiate VF and VT from sinus rhythm in patients undergoing defibrillator implantation?
Electrogram analysis methods reliably discriminate between sinus rhythm and VF, but require the addition of hemodynamic data like aortic pressure to accurately differentiate VT from life-threatening rhythms.
Recognition of ventricular fibrillation (VF) and tachycardia (VT) and differentiating life-threatening situations from physiological high rhythms remains a difficult problem. In order to improve detection ability, electrogram analysis was performed using three different methods: the autocorrelation function (ACF), the probability-density function (PDF) and the power-spectrum (fast Fourier transform). During the implantation of an automatic defibrillator in 11 patients, electrograms were obtained from a bipolar electrode in the right ventricle, from an intracardiac spring-epicardial patch, and the ECG. Aortic pressure (AP) was also recorded. VT and VF were induced using AC current or programmed stimulation. Each sinus rhythm (SR) and VF episode could be properly identified using either analysis method. The frequency spectra during VF (peak in the band 4-6 Hz) were significantly different from SR (peaks at heart rate and harmonics). Some VT were missed using ACF and/or PDF. Including AP in the detection algorithm allowed a 100% recognition. The results indicate that all electrogram analysis methods perform well for reliable discrimination between SR and VF but are not very successful in differentiating physiologic VT from life-threatening rhythms.>
Aubert et al. (Mon,) conducted a observational in Ventricular fibrillation and tachycardia (n=11). Electrogram analysis (ACF, PDF, power-spectrum) and aortic pressure was evaluated on Recognition of ventricular fibrillation and tachycardia. Electrogram analysis methods reliably discriminated between sinus rhythm and VF, but including aortic pressure in the detection algorithm allowed 100% recognition of VT.
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