Atrial Fibrillation Detection and R-Wave Synchronization by Metrix Implantable Atrial Defibrillator
| Autor: | C.-P. Lau, Harry J.G.M. Crijns, J. S. Sra, N. Edvardsson, S. Kacet, D. G. Wyse, Hung-Fat Tse |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Fibrillation
medicine.medical_specialty Atrium (architecture) Defibrillation business.industry medicine.medical_treatment Atrial fibrillation medicine.disease QRS complex Physiology (medical) Internal medicine Ventricular fibrillation medicine Cardiology Sinus rhythm Electrical conduction system of the heart medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Circulation. 99:1446-1451 |
| ISSN: | 1524-4539 0009-7322 |
| DOI: | 10.1161/01.cir.99.11.1446 |
| Popis: | Background —The long-term efficacy of atrial fibrillation (AF) detection and R-wave synchronization are critical safety requirements for the development of an implantable atrial defibrillator (IAD) for treatment of AF. Methods and Results —The long-term efficacy of the Metrix IAD for AF detection and R-wave synchronization was tested in 51 patients. The mean duration of follow-up was 259±138 days (72 to 613 days). AF detection tests were performed 2240 times during observed operation with 100% specificity and 92.3% sensitivity for differentiation between sinus rhythm and AF; 2219 episodes and their electrograms stored in the device during AF detection were analyzed. The positive predictive value of the AF detection algorithm was 97.4% (lower 95% confidence limit [CL], 94.5%) in the out-of-hospital setting. A total of 242 435 R waves were analyzed for R-wave synchronization. Of these, 49% were marked for synchronized shock delivery, 82% of sinus rhythm and 36% of AF R waves, respectively. All shock markers were properly synchronized and within the R wave (overall synchronization accuracy, 100%; lower 95% CL, 99.999%). Overall, 3719 shocks have been delivered via the IAD with no instance of unsynchronized shock delivery or any episode of proarrhythmia. The observed proarrhythmic risk was 0%, with an estimated maximum proarrhythmic risk of 0.084% per shock (95% upper CL). Conclusions —The Metrix IAD can appropriately detect AF with a high specificity and sensitivity and reliably synchronize within a suitable R wave for shock delivery to minimize the risk of ventricular proarrhythmia. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|