Ventricular fibrillation detection using the evoked electrogram from the braided endocardial defibrillation lead

Life-threatening consequences can be the result of inappropriate classification of ventricular fibrillation for patients with implantable cardioverter defibrillators. The objective of this study was to determine if analysis of the asynchronously paced evoked electrogram using the braided endocardial defibrillation lead could improve the detection of ventricular fibrillation. The depolarization portion of the evoked electrogram was integrated to obtain the paced depolarization integral. The results demonstrated that the mean of the paced depolarization integral, its SD, and the mean +/- SD were significantly different between sinus rhythm and ventricular fibrillation (p < 0.005, p < 0.05, p < 0.01, respectively). These results suggest that the paced depolarization integral obtained with the braided endocardial defibrillation lead could improve the specificity and sensitivity of ventricular fibrillation detection.