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Related Experiment Videos

Ventricular tachycardia detection using bipolar electrogram analysis is site specific.

L A DiCarlo1, J M Jenkins, C M Chiang

  • 1Department of Electrical Engineering and Computer Science, College of Engineering, University of Michigan, Ann Arbor.

Pacing and Clinical Electrophysiology : PACE
|November 1, 1992
PubMed
Summary
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Bipolar electrogram analysis can detect ventricular tachycardia (VT), but its accuracy for implantable devices depends on electrode placement within the right ventricle. Electrode location impacts VT detection sensitivity.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Electrophysiology

Background:

  • Algorithms analyzing bipolar intraventricular electrograms can aid in detecting ventricular tachycardia (VT).
  • These algorithms may complement existing rate-based criteria used in implantable antitachycardia devices.
  • The impact of electrogram detection site on algorithm sensitivity remains largely undetermined.

Purpose of the Study:

  • To evaluate the sensitivity of bipolar intraventricular electrogram analysis algorithms to the intracavitary detection site.
  • To determine if electrode repositioning within the right ventricle affects the accuracy of VT detection.
  • To assess the feasibility of differentiating VT from sinus rhythm (SR) using morphological analysis at different electrode locations.

Main Methods:

Related Experiment Videos

  • Unfiltered bipolar electrograms were recorded from 12 patients during sinus rhythm (SR) and induced monomorphic VT.
  • Recordings were performed at two distinct sites within the right ventricular (RV) apex using a bipolar electrode catheter.
  • Correlation waveform analysis compared SR and VT electrogram templates at each site, with a 0.9 correlation threshold for discrimination.

    • Main Results:

    • VT was differentiated from SR in 11/12 patients (91%) overall using morphological analysis.
    • Discrimination accuracy varied by site: 67% at the initial site (site 1) and 75% at the repositioned site (site 2).
    • Accurate differentiation at both sites occurred in 50% of patients, indicating site-dependent performance.

    Conclusions:

    • Morphological analysis of bipolar RV electrograms can discriminate between VT and SR.
    • The accuracy of this analysis is influenced by the intracavitary electrode location.
    • Electrode positioning is a critical factor for optimal performance of VT detection algorithms in selected patients.