Influence of myopotential interference on the Wavelet discrimination algorithm in implantable cardioverter-defibrillator

Kazuya Mizukami, Hisashi Yokoshiki, Hirofumi Mitsuyama, Masaya Watanabe, Taro Tenma, Rui Kamada, Masayuki Takahashi, Ryo Sasaki, Motoki Maeno, Hiroyuki Tsutsui

研究成果: ジャーナルへの寄稿記事

抜粋

Background Wavelet is a morphology-based algorithm for detecting ventricular tachycardia. The electrogram (EGM) source of the Wavelet algorithm is nominally programmed with the Can-RV coil configuration, which records a far-field ventricular potential. Therefore, it may be influenced by myopotential interference. Methods We performed a retrospective review of 40 outpatients who had an implantable cardioverter-defibrillator (ICD) with the Wavelet algorithm. The percent-match score of the Wavelet algorithm was measured during the isometric chest press by pressing the palms together. We classified patients with percent-match scores below 70% due to myopotential interference as positive morphology change, and those with 70% or more as negative morphology change. Stored episodes of tachycardia were evaluated during the follow-up. Results The number of patients in the positive morphology change group was 22 (55%). Amplitude of the Can-RV coil EGM was lower in the positive morphology change group compared to that in the negative group (3.9±1.3 mV vs. 7.4±1.6 mV, P=0.0015). The cut-off value of the Can-RV coil EGM was 5 mV (area under curve, 0.89). Inappropriate detections caused by myopotential interference occurred in two patients (5%) during a mean follow-up period of 49 months, and one of them received an inappropriate ICD shock. These patients had exhibited positive morphology change. Conclusions The Wavelet algorithm is influenced by myopotential interference when the Can-RV coil EGM is less than 5 mV.

元の言語英語
ページ(範囲)214-219
ページ数6
ジャーナルjournal of arrhythmia
33
発行部数3
DOI
出版物ステータス出版済み - 6 2017
外部発表Yes

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All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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