Tachycardia detection in modern implantable cardioverter–defibrillators
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- 作者：Dipl.-Ing. Thomas Brüggemann ; Daniel Dahlke…
- 关键词：BIOTRONIK ; Implantable cardioverter defibrillator ; Ventricular fibrillation ; Ventricular tachycardia ; Tachycardia discrimination ; Single ; chamber detection ; Dual ; chamber detection
- 刊名：Herzschrittmachertherapie und Elektrophysiologie
- 出版年：2016
- 出版时间：September 2016
- 年：2016
- 卷：27
- 期：3
- 页码：171-185
- 全文大小：3,452 KB
- 刊物类别：Medicine
- 刊物主题：Medicine & Public Health
Cardiology - 出版者：Springer Berlin / Heidelberg
- ISSN：1435-1544
- 卷排序：27
文摘
Implantable cardioverter–defibrillators (ICD) have to reliably sense, detect, and treat malignant ventricular tachyarrhythmias. Inappropriate treatment of non life-threatening tachyarrhythmias should be avoided. This article outlines the functionality of ICDs developed and manufactured by BIOTRONIK. Proper sensing is achieved by an automatic sensitivity control which can be individually tailored to solve special under- and oversensing situations. The programming of detection zones for ventricular fibrillation (VF), ventricular tachycardia (VT), and zones to monitor other tachyarrhythmias is outlined. Dedicated single-chamber detection algorithms based on average heart rate, cycle length variability, sudden rate onset, and changes in QRS morphology as used in ICDs by BIOTRONIK are described in detail. Preconditions and confirmation algorithms for therapy deliveries as antitachycardia pacing (ATP) and high energy shocks are explained. Finally, a detailed description of the dual-chamber detection algorithm SMART is given. It comprises additional detection criteria as stability of atrial intervals, 1:1 conduction, atrial–ventricular (AV) multiplicity, AV trend, and AV regularity to differentiate between ventricular and supraventricular tachyarrhythmias.