Matches in SemOpenAlex for { <https://semopenalex.org/work/W4377015883> ?p ?o ?g. }
Showing items 1 to 57 of
57
with 100 items per page.
- W4377015883 endingPage "S59" @default.
- W4377015883 startingPage "S58" @default.
- W4377015883 abstract "Accurate differentiation between SVT and malignant ventricular tachyarrhythmias in ICDs is augmented with the use of device specific SVT discriminators. However, these enhancements rely on nonprogrammable algorithms that on occasion may be responsible for inappropriate withholding of VT/VF therapy. It is important to understand the reason for rhythm misclassifications so that opportunities for improvement in ICD programming can be identified. N/A A 46-year-old man with ischemic cardiomyopathy, severe left ventricular dysfunction, left bundle branch block, prior VF arrest, AF on amiodarone therapy with a Medtronic Claria CRT-D suffered a sudden cardiac arrest at home. ICD parameter settings are noted in Table. ICD electrograms showed initial monomorphic VT with cycle length 340 ms which was treated with burst anti-tachycardia pacing that resulted in a slower VT below the VT detection rate of 162 bpm. This was sustained for 5 minutes until the rhythm devolved to VF and met the criteria for VT/VF event using the combined count number of intervals to detect (CCNID, Figure). SVT discrimination was applied as the median V-V interval was greater than the programmed SVT limit of 260 ms due to occasional undersensing. The SVT discrimination feature is designed to confirm 1:1 AV conduction using pre-specified criteria. The algorithm then relies on a simultaneous sinus tachycardia (ST) count that is established using an analysis of expected RR intervals and successive PR intervals concurrently calculated. A minimum ST count of 6 was fulfilled leading to classification of the event as sinus tachycardia and withholding for VT/VF therapy (Figure). Hierarchy of sinus tachycardia in the SVT discrimination logic withholds application of waveform analysis. Criteria for VT/VF event was met 1 minute later again based on CCNID. A 36J shock was delivered unsuccessfully terminating the rhythm. Ongoing VF was undersensed in the presence of high output post shock pacing. This case illustrates several failures of tachyarrhythmia detection leading to a tragic failure of ICD therapy. Algorithm features such as the minimum requirements for 1:1 AV conduction, sinus tachycardia counter, and hierarchy of the SVT discrimination feature to withhold waveform analysis led to inappropriate withholding of therapy for VF. Understanding elements of these complex algorithms may be helpful for individualizing device program and in future development of additional SVT discrimination enhancements." @default.
- W4377015883 created "2023-05-19" @default.
- W4377015883 creator A5082580579 @default.
- W4377015883 creator A5084490449 @default.
- W4377015883 date "2023-05-01" @default.
- W4377015883 modified "2023-10-01" @default.
- W4377015883 title "CE-454610-4 A CASE OF INAPPROPRIATE CLASSIFICATION OF VENTRICULAR FIBRILLATION AS SINUS TACHYCARDIA" @default.
- W4377015883 doi "https://doi.org/10.1016/j.hrthm.2023.03.323" @default.
- W4377015883 hasPublicationYear "2023" @default.
- W4377015883 type Work @default.
- W4377015883 citedByCount "0" @default.
- W4377015883 crossrefType "journal-article" @default.
- W4377015883 hasAuthorship W4377015883A5082580579 @default.
- W4377015883 hasAuthorship W4377015883A5084490449 @default.
- W4377015883 hasBestOaLocation W43770158831 @default.
- W4377015883 hasConcept C126322002 @default.
- W4377015883 hasConcept C164705383 @default.
- W4377015883 hasConcept C2775914520 @default.
- W4377015883 hasConcept C2776331378 @default.
- W4377015883 hasConcept C2777093960 @default.
- W4377015883 hasConcept C2777473070 @default.
- W4377015883 hasConcept C2778094803 @default.
- W4377015883 hasConcept C2778198053 @default.
- W4377015883 hasConcept C2779161974 @default.
- W4377015883 hasConcept C2781005686 @default.
- W4377015883 hasConcept C71924100 @default.
- W4377015883 hasConceptScore W4377015883C126322002 @default.
- W4377015883 hasConceptScore W4377015883C164705383 @default.
- W4377015883 hasConceptScore W4377015883C2775914520 @default.
- W4377015883 hasConceptScore W4377015883C2776331378 @default.
- W4377015883 hasConceptScore W4377015883C2777093960 @default.
- W4377015883 hasConceptScore W4377015883C2777473070 @default.
- W4377015883 hasConceptScore W4377015883C2778094803 @default.
- W4377015883 hasConceptScore W4377015883C2778198053 @default.
- W4377015883 hasConceptScore W4377015883C2779161974 @default.
- W4377015883 hasConceptScore W4377015883C2781005686 @default.
- W4377015883 hasConceptScore W4377015883C71924100 @default.
- W4377015883 hasIssue "5" @default.
- W4377015883 hasLocation W43770158831 @default.
- W4377015883 hasOpenAccess W4377015883 @default.
- W4377015883 hasPrimaryLocation W43770158831 @default.
- W4377015883 hasRelatedWork W2009378781 @default.
- W4377015883 hasRelatedWork W2024269966 @default.
- W4377015883 hasRelatedWork W2027787775 @default.
- W4377015883 hasRelatedWork W2030004221 @default.
- W4377015883 hasRelatedWork W2046147094 @default.
- W4377015883 hasRelatedWork W2047308681 @default.
- W4377015883 hasRelatedWork W2087463524 @default.
- W4377015883 hasRelatedWork W2131262499 @default.
- W4377015883 hasRelatedWork W2379338342 @default.
- W4377015883 hasRelatedWork W2887026087 @default.
- W4377015883 hasVolume "20" @default.
- W4377015883 isParatext "false" @default.
- W4377015883 isRetracted "false" @default.
- W4377015883 workType "article" @default.