[Stored intracardiac electrograms: accuracy of arrhythmia classification in patients with cardioverter/defibrillator system].
A cardioverter/defibrillator that is capable of storing endocardial electrograms before and after electrical device therapy was implanted in 29 patients presenting drug refractory ventricular arrhythmias. During a follow-up period of 7.5 +/- 4.6 months 15/29 patients (51%) experienced a total number of 112 pulse generator discharges. In 104 arrhythmia episodes the stored electrogram was analyzed. Morphological criterias of the stored electrogram as detectable P-waves and changes in the QRS-morphology during tachycardia compared to sinus rhythm served for classification of the documented arrhythmia. The analysis of the stored electrogram established a definitive diagnosis of the arrhythmia and allows to distinguish supraventricular arrhythmias from ventricular arrhythmias in every episode. 72/104 (69.2%) of the discharges were classified as appropriate, 32/104 (30.8%) of the device discharges were not appropriate and caused by atrial fibrillation and flutter, sinustachycardia and AV-nodal reentrant tachycardia. In two patients device discharges caused by a sensing malfunction ot the pulse generator was detected by the analysis of the stored electrogram. The new diagnostic feature of stored electrogram shows a high accuracy of rhythm classification and represents a major advance in the treatment with cardioverter/defibrillators.
Neuzner
J
J
Kerckhoff-Klinik, Institut der Max-Planck-Gesellschaft, Bad Nauheim.
Pitschner
H F
HF
König
S
S
Stöhring
R
R
Schlepper
M
M
D000368:Aged; D009202:Cardiomyopathies / Q000150:complications / Q000628:therapy; D017147:Defibrillators, Implantable; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000295:instrumentation*; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000628:therapy; D017202:Myocardial Ischemia / Q000150:complications / Q000628:therapy; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation; D012984:Software; D013617:Tachycardia, Supraventricular / Q000145:classification* / Q000175:diagnosis / Q000628:therapy; D017180:Tachycardia, Ventricular / Q000145:classification* / Q000175:diagnosis / Q000628:therapy
Gespeicherte intrakardiale Elektrogramme: Genauigkeit der Arrhythmieklassifikation bei Patienten mit Kardioverter/Defibrillator-System.