The use of signal analyses of ventricular tachycardia electrograms to predict the response of antitachycardia pacing in patients with implantable cardioverter-defibrillators

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题名:	The use of signal analyses of ventricular tachycardia electrograms to predict the response of antitachycardia pacing in patients with implantable cardioverter-defibrillators
作者:	林澂;TUAN, TA-CHUAN;LO, MEN-TZUNG;LIN, YENN-JIANG;HSIEH, WAN-HSIN;LIN, CHEN;HUANG, NORDEN E.;LO, LI-WEI;CHAO, TZE-FAN;LIAO, JO-NAN;HSIEH, YU-CHENG;WU, TSU-JUEY;CHEN, SHIH-ANN
贡献者:	生醫理工學院生醫科學與工程學系
关键词:	Aged;Aged, 80 and over;antitachycardia pacing;Cardiac Pacing, Artificial - methods;Cohort Studies;Defibrillators, Implantable;Electrocardiography - instrumentation;Electrocardiography - methods;electrogram;Female;Humans;implantable cardioverter-defibrillator;Male;Middle Aged;Predictive Value of Tests;signal analysis;Signal Processing, Computer-Assisted - instrumentation;Tachycardia, Ventricular - physiopathology;Tachycardia, Ventricular - therapy;ventricular tachycardia
日期:	2014-01-01
上传时间:	2026-04-23 11:23:02 (UTC+8)
出版者:	Wiley-Blackwell Publishing Ltd;United States: Blackwell Publishing Ltd
摘要:	摘要： ICDs and Signal Analyses Introduction Antitachycardia pacing (ATP), a quick, painless, and effective therapy available in implantable cardioverter‐defibrillators (ICDs), can terminate most, but not all, sustained ventricular tachycardias (VTs). This study investigated the possible ventricular electrogram (EGM) factors for predicting the effectiveness of ATP therapy from ICD recordings. Methods and Results In this study, we analyzed 113 EGMs of VT episodes acquired from 20 patients who received ATP or shock to terminate tachyarrhythmias during follow‐up after ICD implantations. The relationship between the outcome of ATP and VT EGM features (such as voltage, width, cycle length, and beat‐to‐beat morphologic variation) was investigated. The divergence (beat‐to‐beat morphologic variation) of the VT EGMs was determined by calculating the total deviation of all EGMs away from the average template after all VT EMGs were aligned. In total, 72 (63.7%) successful (Group I) and 41 (36.3%) unsuccessful (Group II) ATP therapy episodes were analyzed. The mean amplitude, cycle length, and EGM width were similar between these 2 groups (P > 0.05). A multivariate analysis demonstrated that the only predictor of successful ATP was the divergence among the VT EGMs (0.56 ± 0.32 vs 1.07 ± 0.64, P < 0.001, for Groups 1 and 2, respectively). The optimal cutoff value for determining a successful ATP therapy was 0.73 (with an area under the curve of 0.769, sensitivity of 81.9% [95% CI = 71.1–90.0], and specificity of 65.9% [95% CI = 49.4–79.9], P < 0.0001). Conclusion Signal analyses from stored EGMs of VT can predict the response of ATP therapy in patients with ICD implantations. A lesser ventricular beat‐to‐beat morphologic variation in the intracardiac recordings from ICDs correlated with a higher probability of a successful ATP. 其他題名： J Cardiovasc Electrophysiol 出版者： United States: Blackwell Publishing Ltd 出版日期： 2014-04 出處： Journal of cardiovascular electrophysiology, 2014-04, Vol.25 (4), p.411-417 資源來源： Wiley Online Library - AutoHoldings Journals 版權： 2013 Wiley Periodicals, Inc. 版權： Copyright © 2014 Wiley Periodicals, Inc. 識別號： ISSN: 1045-3873 識別號： ISSN: 1540-8167 識別號： EISSN: 1540-8167 識別號： DOI: 10.1111/jce.12340 識別號： PMID: 24320556
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