Open AccessInfluence of myopotential interference on the Wavelet discrimination algorithm in implantable cardioverter‐defibrillator
Author(s) -
Mizukami Kazuya,
Yokoshiki Hisashi,
Mitsuyama Hirofumi,
Watanabe Masaya,
Tenma Taro,
Kamada Rui,
Takahashi Masayuki,
Sasaki Ryo,
Maeno Motoki,
Tsutsui Hiroyuki
Publication year - 2017
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1016/j.joa.2016.08.005
Subject(s) - medicine , cardiology , ventricular tachycardia , implantable cardioverter defibrillator , algorithm , wavelet , artificial intelligence , mathematics , computer science
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.