Augmented two-channel arrhythmia detection: an efficient diagnostic method for implantable devices.
ICDs are highly effective in preventing sudden cardiac death. However, inappropriate device shocks caused by false-positive diagnoses are estimated to happen in 20% of all patients. The need for implantable electrical devices to detect with precision arrhythmias requiring therapy has spawned a variety of proposals for better means of tachycardia identification. To address this problem, the augmented two-channel arrhythmia detection (A2CAD) algorithm, a real-time scheme utilizing timing and morphology from both the atrial and ventricular channels, is introduced. The algorithm uses rate detection as a first stage and augments this with morphological signal analysis in rhythms that confound the rate only diagnoses. The software executes in real-time (online), and has been tested on 60 passages of two-channel intracardiac signals. The following arrhythmias constituted the test set: 10 AF and/or atrial flutter; 15 SVT; 16 VT; 10 ventricular flutter or VF; 5 sinus tachycardia; and 4 cases of AF concurrent with VF. Results from 60 patient cases indicate 57 (95%) of 60 success rate for A2CAD, validating its potential for implementation in future implantable devices.
Chiang
C M
CM
Department of Electrical Engineering, University of Michigan, Ann Arbor, USA.
Jenkins
J M
JM
Caswell
S A
SA
Stevenson
S A
SA
DiCarlo
L A
LA
D000465:Algorithms; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000628:therapy; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000628:therapy; D001282:Atrial Flutter / Q000175:diagnosis / Q000628:therapy; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D004582:Electronics, Medical; D006801:Humans; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000628:therapy