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The Value of Rate Regularity and Multiplicity Measures to Detect Ventricular Tachycardia in the Presence of Atrial Fibrillation or Flutter
Author(s) -
CHIANG CHIHMING JAMES,
JENKINS JANICE M.,
DiCARLO LORENZO A.
Publication year - 1994
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.1540-8159.1994.tb01515.x
Subject(s) - medicine , atrial flutter , cardiology , atrial fibrillation , flutter , ventricular tachycardia , ventricular rate , fibrillation , false positive paradox , tachycardia , implantable cardioverter defibrillator , sinus rhythm , machine learning , computer science , engineering , aerodynamics , aerospace engineering
The predominant cause of inappropriate therapy by implantable antitachycardia devices with pacing and nonpacing cardioverter defibrillators, is mistaking a fast ventricular response during atrial fibrillation or flutter with true ventricular tachycardia (VT). The distinction between these arrhythmias is an important consideration in addressing the problem of reducing false‐positives in detection mechanisms for implantable devices. Dual chamber analysis that examines atrial and ventricular event ratios has been proposed as a solution to this problem, but would still fail in distinguishing paroxysmal VT requiring treatment from a fast but otherwise benign ventricular response during atrial fibrillation or flutter. In this study, two methods for discriminating these tachyarrhythmias were evaluated. Method 1 examined ventricular rate and rate regularity as a method for VT detection. Method 2 combined rate and regularity as well as an additional multiplicity criterion for recognition of atrial flutter with a fast ventricular response. In 20 patients. Method 1 had 100% sensitivity of VT detection and 80% specificity for detection of atrial fibrillation or flutter. Method 2 had 90% sensitivity and 90% specificity. These results suggest that use of these algorithms in future implantable devices would result in a decrease in false‐positive device therapies.