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Ventricular Tachycardia Detection Using Bipolar Electrogram Analysis is Site Specific
Author(s) -
DiCarlo LORENZO A.,
JENKINS JANICE M.,
CHIANG CHIHMING J.,
WINSTON STUART A.,
SILKA MICHAEL J.,
MATNEY KATHY
Publication year - 1992
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1992.tb03039.x
Subject(s) - medicine , ventricular tachycardia , sinus rhythm , cardiology , correlation coefficient , ventricle , atrial fibrillation , statistics , mathematics
While algorithms for bipolar intraventricular electrogram analysis have potential use in complementing rate criteria for ventricular tachycardia (VT) detection by implantable antitachycardia devices, the sensitivity of such algorithms to the intracavitary site of electrogram detection has not been determined. In this study, unfiltered (1‐500 Hz) electrograms were recorded from a bipolar electrode catheter initially positioned at the right ventricular (RV) apex (site 1) of 12 patients during sinus rhythm (SRI) and during induced monomorphic VT (VTI). Sinus rhythm (SR2) and the identical VT (VT2) were recorded a second time after repositioning the same electrode catheter within the RV apex (site 2) 7‐44 mm (mean ± SD = 15 ± W) from its original site. The data were digitized at 1,000 Hz. Templates from SRI and SR2, respectively, were compared subsequently with individual intraventricular electrograms from 15‐25 sec passages of SRI and VTI and SR2 and VT2, respectively, using correlation waveform analysis. At site 1, the mean patient correlation coefficient ranged from 0.982‐0.998 during SRI and 0.062‐0.975 during VTI. At site 2, the mean patient correlation coefficient ranged from 0.995‐0.998 during SR2 and 0.113‐0.983 during VT2. Using a correlation threshold of 0.9, VT was differentiated from SR in 11/12 patients (91%) overall: 8/12 patients (67%) at site 1, 9/12 patients (75%) at site 2, and 6/12 patients (50%) at both sites. Thus, while discrimination of VT from SR is feasible with morphological analysis of bipolar right ventricular intracavitary electrograms, the accuracy of bipolar intraventricular electrogram analysis may depend upon intracavitary electrode location in selected patients.