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Supraventricular Tachycardia‐Ventricular Tachycardia Discrimination Algorithms in Implantable Cardioverter Defibrillators: State‐of‐the‐Art Review
Author(s) -
SWERDLOW CHARLES D.
Publication year - 2001
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1046/j.1540-8167.2001.00606.x
Subject(s) - medicine , cardiology , ventricular tachycardia , atrial fibrillation , supraventricular tachycardia , implantable cardioverter defibrillator , atrial tachycardia , algorithm , tachycardia , single chamber , catheter ablation , computer science
SVT‐VT Discrimination Algorithms in ICDs. To reduce inappropriate therapy of supraventricular tachycardia (SVT), implantable cardioverter defibrillators (ICDs) include algorithms to discriminate ventricular tachycardia (VT) from SVT. Dual‐chamber algorithms analyze atrial and ventricular rates or AV relationship. They provide advantages over single‐chamber algorithms, but introduce new ways to detect SVT as VT inappropriately and to underdetect VT. Unlike pacemakers, dual‐chamber ICDs require accurate atrial sensing during high ventricular rates. A postventricular atrial blanking period prevents oversensing of far‐field R waves as atrial electrograms, but causes underdetection of atrial fibrillation during high ventricular rates. Tachycardias with 1:1 AV relationship and VT during atrial tachyarrhythmias present specific SVT‐VT discrimination problems. The first dual‐chamber algorithms performed comparably to single‐chamber algorithms. Present dual‐chamber algorithms correct some limitations of earlier versions.