Jones G K, Bardy G H
Department of Medicine, University of Washington School of Medicine, Seattle, WA.
Am Heart J. 1994 Apr;127(4 Pt 2):1107-10. doi: 10.1016/0002-8703(94)90096-5.
Implantable cardioverter defibrillator detection of ventricular fibrillation is inherently a complicated process. Nevertheless, there is a clinical imperative that ventricular fibrillation be detected with 100% sensitivity. Incumbent with the need for such a high sensitivity is a trade-off that results in diminished ventricular fibrillation detection specificity, which in turn results in unnecessary delivery of high-energy shocks. In this review we look in generic terms at the different lead and detection systems available and the effect of these systems on both undersensing and oversensing of ventricular fibrillation. In addition, several clinical and programming issues that affect sensitivity and specificity of ventricular fibrillation detection are reviewed.
植入式心脏复律除颤器对心室颤动的检测本质上是一个复杂的过程。然而，临床上迫切需要以100%的敏感性检测到心室颤动。为了达到如此高的敏感性，需要进行权衡，这导致心室颤动检测特异性降低，进而导致不必要地发放高能量电击。在本综述中，我们从一般角度审视了现有的不同导联和检测系统，以及这些系统对心室颤动感知不足和感知过度的影响。此外，还综述了影响心室颤动检测敏感性和特异性的几个临床和程控问题。
