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Real‐Time Arrhythmia Identification from Automated Analysis of Intraatrial and Intraventricular Electrograms
Author(s) -
CHIANG CHIHMING J.,
JENKINS JANICE M.,
DICARLO LORENZO A.,
LIN DONGPINC,
LI PAICHI
Publication year - 1993
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.1540-8159.1993.tb01566.x
Subject(s) - medicine , atrial flutter , cardiology , intracardiac injection , ventricular tachycardia , supraventricular tachycardia , atrial fibrillation , tachycardia , ventricular fibrillation , electrocardiography
Implantable cardioverter defibrillators have dramatically improved survival rates for patients at risk of sudden cardiac death, but the occurrence of inappropriate shocks remains an unresolved problem. Various means for better tachycardia detection, chiefly morphological analysis, have been proposed to address this problem. A new computerized scheme entitled Two‐Channel Rate‐Morphology (2CRM) was introduced. It is a real‐time arrhythmia detection algorithm that combines timing and morphology information from intraatrial and intraventricular electrograms for arrhythmia diagnosis. The program 2CRM applies an initial cycle‐by‐cycle coding scheme followed by contextual diagnosis of underlying rhythm. The program was tested on 36 distinct passages of two‐channel intracardiac signals from 30 patients. The distribution of the arrhythmias are as follows: 4 atrial fibrillation, 6 atrial flutter, 6 supraventricular tachycardia, 10 ventricular tachycardia, and 10 ventricular flutter‐fibrillation. Of the analyzed 3,417 individual cardiac cycles 3,135 (91.7%) were correctly identified. Contextual diagnosis reversed 123 single‐cycle errors to obtain a performance of 3,258 correct out of 3,417 (95.3%). Utilizing an uninterrupted continuous correct contextual diagnosis as indicator of successful arrhythmia detection, 2CRM obtained an accuracy of 34 out of 36 passages (94.4%).