Abstract
An automatic external cardioverter-defibrillator (AECD) with a programmable supraventricular–ventricular
tachycardia (VT) zone underwent evaluation of arrhythmia discrimination performance
in the electrophysiologic laboratory during induced supraventricular tachycardia (SVT)
and unipolar and bipolar atrial pacing. The AECD SVT zone was programmed so that the
induced SVT rate would fall within this zone. Atrial pacing was also performed at
a rate within this zone. The ability of the AECD to accurately discriminate between
VT and SVT and to recommend shock delivery was assessed. A total of 98 patients underwent
conventional diagnostic electrophysiologic studies (49 men, age 59 ± 19 years) with
a total of 55 inducible sustained SVTs. High right atrial pacing was performed in
56 patients in unipolar and in 82 patients in bipolar fashion. In response to induced
sustained SVT, the AECD correctly classified 47 episodes as nonshockable, 4 incorrectly
as shockable, and 4 episodes correctly as shockable with a resultant sensitivity of
100% and specificity of 92%. Bipolar high right atrial pacing was correctly identified
as nonshockable in 75 episodes, incorrectly identified as shockable in 5 episodes,
and correctly identified as shockable in 2 episodes with a resultant sensitivity of
100% and specificity of 94%. The Powerheart AECD accurately discriminates SVT from
VT and is expected to correctly deliver automatic external shocks rapidly in the presence
of spontaneous life-threatening tachycardia and appropriately withhold therapy during
SVT.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Is cardiac resuscitation worthwhile? A decade of experience.N Engl J Med. 1972; 286: 970-972
- In-hospital cardiopulmonary resuscitation.Cardiopulmon Resus. 1995; 74: 163-175
- In-hospital cardiopulmonary resuscitation.J Am Board Fam Pract. 1993; 6: 91-101
- Response to cardiac arrests in a hospital setting.Resuscitation. 1996; 31: 17-23
- Outcome of adult cardiopulmonary resuscitations at a tertiary referral center including results of “limited” resuscitations.Arch Intern Med. 2001; 161: 1751-1758
- Improving outcome from cardiac arrest in the hospital with a reorganized and strengthened chain of survival.Resuscitation. 1996; 31: 181-186
- Predictors of survival of in-hospital cardiac arrest.Can J Cardiol. 1991; 7: 113-116
Mattioni TA, Brodsky M, Riggio D, Allen B, Fisher J, Ybarra R, Lin D. Enhanced response times to tachyarrhythmias using a new automatic external cardioverter-defibrillator. Eur J Cardiac Pacing Electrophysiol 1994;4:671
- Initial clinical experience with a fully automatic in-hospital external cardioverter-defibrillator.PACE. 1999; 22: 1648-1655
Martinez-Rubio A, Kanaan N, Borggrefe M, Block M, Makijarvi M, Fedele F, Pappone C, Haverkamp W, Merino JL, Esquivas GB, Cinca J, for the European Powerheart Investigators. Advances for treating in-hospital cardiac arrest: safety and effectiveness of a new automatic external cardioverter-defibrillator. J Am Coll Cardiol 2003;41:627–632.
Article info
Publication history
Accepted:
February 12,
2003
Received in revised form:
February 12,
2003
Received:
October 14,
2002
Identification
Copyright
© 2003 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
