Electrogram morphology discriminators in implantable cardioverter defibrillators: A comparative evaluation

Background Morphology algorithms are currently recommended as a standalone discriminator in single‐chamber implantable cardioverter defibrillators (ICDs). However, these proprietary algorithms differ in both design and nominal programming. Objective To compare three different algorithms with nominal...

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Bibliographic Details
Published in:Journal of cardiovascular electrophysiology 2020-06, Vol.31 (6), p.1493-1506
Main Authors: Frontera, Antonio, Strik, Marc, Eschalier, Romain, Biffi, Mauro, Pereira, Bruno, Welte, Nicolas, Chauvel, Remi, Mondoly, Pierre, Laborderie, Julien, Bernis, Jean‐Paul, Clementy, Nicolas, Reuter, Sylvain, Garrigue, Stéphane, Deplagne, Antoine, Vernooy, Kevin, Pillois, Xavier, Haïssaguerre, Michel, Dubois, Remi, Ritter, Philippe, Bordachar, Pierre, Ploux, Sylvain
Format: Article
Language:English
Subjects:
Action Potentials
algorithm
Algorithms
arrhythmia
Defibrillators
Defibrillators, Implantable
Diagnosis, Differential
discrimination
Electric Countershock - instrumentation
Electrophysiologic Techniques, Cardiac - instrumentation
Equipment Design
Europe
Heart Rate
Humans
implantable cardioverter defibrillator
Morphology
Predictive Value of Tests
Reproducibility of Results
Retrospective Studies
Signal Processing, Computer-Assisted
Stents
Tachycardia
Tachycardia, Supraventricular - diagnosis
Tachycardia, Supraventricular - physiopathology
Tachycardia, Supraventricular - therapy
Tachycardia, Ventricular - diagnosis
Tachycardia, Ventricular - physiopathology
Tachycardia, Ventricular - therapy
Telemetry - instrumentation
Ventricle
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Summary:Background Morphology algorithms are currently recommended as a standalone discriminator in single‐chamber implantable cardioverter defibrillators (ICDs). However, these proprietary algorithms differ in both design and nominal programming. Objective To compare three different algorithms with nominal versus advanced programming in their ability to discriminate between ventricular (VT) and supraventricular tachycardia (SVT). Methods In nine European centers, VT and SVTs were collected from Abbott, Boston Scientific, and Medtronic dual‐ and triple‐chamber ICDs via their respective remote monitoring portals. Percentage morphology matches were recorded for selected episodes which were classified as VT or SVT by means of atrioventricular comparison. The sensitivity and related specificity of each manufacturer discriminator was determined at various values of template match percentage from receiving operating characteristics (ROC) curve analysis. Results A total of 534 episodes were retained for the analysis. In ROC analyses, Abbott Far Field MD (area under the curve [AUC]: 0.91; P 
ISSN:1045-3873
1540-8167
DOI:10.1111/jce.14518