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Influence of myopotential interference on the Wavelet discrimination algorithm in implantable cardioverter-defibrillator

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Title: Influence of myopotential interference on the Wavelet discrimination algorithm in implantable cardioverter-defibrillator
Authors: Mizukami, Kazuya Browse this author
Yokoshiki, Hisashi Browse this author →KAKEN DB
Mitsuyama, Hirofumi Browse this author
Watanabe, Masaya Browse this author
Tenma, Taro Browse this author
Kamada, Rui Browse this author
Takahashi, Masayuki Browse this author
Sasaki, Ryo Browse this author
Maeno, Motoki Browse this author
Tsutsui, Hiroyuki Browse this author →KAKEN DB
Keywords: Implantable cardioverter-defibrillator
Tachycardia discrimination
Myopotential interference
Issue Date: Jun-2017
Publisher: Elsevier
Journal Title: Journal of arrhythmia
Volume: 33
Issue: 3
Start Page: 214
End Page: 219
Publisher DOI: 10.1016/j.joa.2016.08.005
Abstract: Background: Wavelet is a morphology-based algorithm for detecting ventricular tachycardia. The electrogram (EGM) source of the Wavelet algorithm is nominally programmed with the Can-RV coil configuration, which records a far-field ventricular potential. Therefore, it may be influenced by myopotential interference. Methods: We performed a retrospective review of 40 outpatients who had an implantable cardioverter-defibrillator (LCD) with the Wavelet algorithm. The percent-match score of the Wavelet algorithm was measured during the isometric chest press by pressing the palms together. We classified patients with percent-match scores below 70% due to myopotential interference as positive morphology change, and those with 70% or more as negative morphology change. Stored episodes of tachycardia were evaluated during the follow-up. Results: The number of patients in the positive morphology change group was 22 (55%). Amplitude of the Can-RV coil EGM was lower in the positive morphology change group compared to that in the negative group (3.9 +/- 1.3 mV vs. 7.4 +/- 1.6 mV, P=0.0015). The cut-off value of the Can-RV coil EGM was 5 mV (area under curve, 0.89). Inappropriate detections caused by myopotential interference occurred in two patients (5%) during a mean follow-up period of 49 months, and one of them received an inappropriate LCD shock. These patients had exhibited positive morphology change. Conclusions: The Wavelet algorithm is influenced by myopotential interference when the Can-RV coil EGM is less than 5 mV.
Type: article
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 横式 尚司

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