Throne R D, Jenkins J M, DiCarlo L A
Pritzker Institute of Medical Engineering, Chicago, IL 60616.
IEEE Trans Biomed Eng. 1991 Jun;38(6):561-70. doi: 10.1109/10.81581.
Electrical management of intractable tachycardia via implantable antitachycardia devices has become a major form of therapy. Newly advanced methods of ventricular tachycardia detection propose examination of changes in intraventricular electrogram morphology in addition to or in combination with earlier rate-based detection algorithms. Unfortunately, most of the proposed morphology analysis techniques have computational demands beyond the capabilities of present devices or may be adversely affected by amplitude and baseline fluctuations of the intraventricular electrogram. We have designed four new computationally efficient time-domain algorithms for distinguishing ventricular electrograms during monomorphic ventricular tachycardia (VT) from those during sinus rhythm using direct analysis of the ventricular electrogram morphology. All four techniques are independent of amplitude fluctuations and three of the four are independent of baseline changes. These new techniques were compared to correlation waveform analysis, a previously proposed method for distinction of VT from sinus rhythm. Evaluation of these four new algorithms was performed on data from 19 consecutive patients with 31 distinct monomorphic ventricular tachycardia morphologies. Three of the algorithms performed as well or better than correlation waveform analysis but with one-tenth to one-half the computational demands.
通过植入式抗心动过速装置对顽固性心动过速进行电管理已成为一种主要的治疗方式。新提出的室性心动过速检测方法除了基于心率的早期检测算法外，还建议检查心室内电图形态的变化，或将两者结合起来。不幸的是，大多数提出的形态分析技术的计算要求超出了现有设备的能力，或者可能受到心室内电图幅度和基线波动的不利影响。我们设计了四种新的计算效率高的时域算法，通过直接分析心室内电图形态，来区分单形性室性心动过速（VT）期间的心室内电图和窦性心律期间的心室内电图。所有这四种技术都与幅度波动无关，其中三种与基线变化无关。将这些新技术与相关波形分析进行了比较，相关波形分析是之前提出的一种区分室性心动过速和窦性心律的方法。对19例连续患者的31种不同单形性室性心动过速形态的数据进行了这四种新算法的评估。其中三种算法的表现与相关波形分析一样好或更好，但计算要求仅为其十分之一到二分之一。
