| Autor: |
Tse, HF, Lau, CP, Sra, JS, Crijns, HJGM, Edvardsson, N, Kacet, S, Wyse, DG |
| Přispěvatelé: |
Faculteit Medische Wetenschappen/UMCG |
| Jazyk: |
angličtina |
| Rok vydání: |
1999 |
| Předmět: |
|
| Zdroj: |
Circulation, 99(11), 1446-1451. LIPPINCOTT WILLIAMS & WILKINS |
| ISSN: |
0009-7322 |
| 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 (LAD) 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 LAD 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: |
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