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- W2051254676 abstract "Intracardiac cardioverter defibrillators (ICDs) are expected to detect and to treat ventricular arrhythmias (VAs) in patients with previously documented VAs (secondary indication) or in patients at high risk of occurrence of VAs (primary indication).1,2 The treatment process includes the detection of VAs followed by the delivery of a therapy, i.e. antitachycardia pacing (ATP) and/or shocks. One of the main challenge of the devices is to detect the arrhythmia correctly, including noise rejection, and to identify its origin, i.e. supraventricular or ventricular, and thus to deliver therapy or not. The technical objective is to deliver only appropriate therapy and to avoid inappropriate therapies especially shocks (high specificity), but without the risk of underdetection of a life-threatening arrhythmia (high sensitivity).1,2 The detection and classification of VAs are essentially based on two additional parameters: the ventricular rate and the number of intervals reaching this threshold needed to be detected [number of intervals to be detected (NID)]. As a mandatory first step, these two parameters are fundamental for arrhythmia detection. Additional parameters, only available in the ventricular tachycardia (VT) zone, such as the sudden onset of the episode, the relationship of the atrial and ventricular activities (only in dual-chamber devices), or the intracardiac electrocardiogram (iEGM) morphology may be used for a better arrhythmia classification. Until now any device has not considered the haemodynamic tolerance of VAs to whether on not therapy has been delivered. The optimization of the programming of the delivery of antitachycardia therapy of an ICD is challenging, with the need to treat life-threatening VAs, VT and ventricular fibrillation (VF) urgently and efficiently and the avoidance of inappropriate therapies, especially shocks. Another challenge is not to treat too quickly in order to avoid unnecessary therapies particularly in self-terminating arrhythmias which are relatively frequent, but also not … *Corresponding author. Tel: +33 2 99 28 25 17, Fax: +33 2 99 28 25 18, Email: christophe.leclercq{at}chu-rennes.fr" @default.
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- W2051254676 date "2009-10-27" @default.
- W2051254676 modified "2023-09-26" @default.
- W2051254676 title "Not too late, not too fast!!" @default.
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- W2051254676 doi "https://doi.org/10.1093/eurheartj/ehp446" @default.
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