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Article: Atrial fibrillation detection and R-wave synchronization by metrix implantable atrial defibrillator: Implications for long-term efficacy and safety

TitleAtrial fibrillation detection and R-wave synchronization by metrix implantable atrial defibrillator: Implications for long-term efficacy and safety
Authors
KeywordsAtrium
Defibrillation
Fibrillation
Heart-assist device
Issue Date1999
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://circ.ahajournals.org
Citation
Circulation, 1999, v. 99 n. 11, p. 1446-1451 How to Cite?
AbstractBackground - The long-term efficacy of atrial fibrillation (AF) detection and R-wave synchronization are critical safety requirements for the development of an implantable atrial defibrillator (IAD) for treatment of AF. Methods and Results - The long-term efficacy of the Metrix IAD for AF detection and R-wave synchronization was tested in 51 patients. The mean duration of follow-up was 259 ± 138 days (72 to 613 days). AF detection tests were performed 2240 times during observed operation with 100% specificity and 92.3% sensitivity for differentiation between sinus rhythm and AF; 2219 episodes and their electrograms stored in the device during AF detection were analyzed. The positive predictive value of the AF detection algorithm was 97.4% (lower 95% confidence limit [CL], 94.5%) in the out-of- hospital setting. A total of 242 435 R waves were analyzed for R-wave synchronization. Of these, 49% were marked for synchronized shock delivery, 82% of sinus rhythm and 36% of AFR waves, respectively. All shock markers were properly synchronized and within the R wave (overall synchronization accuracy, 100%; lower 95% CL, 99.999%). Overall, 3719 shocks have been delivered via the IAD with no instance of unsynchronized shock delivery or any episode of proarrhythmia. The observed proarrhythmic risk was 0%, with an estimated maximum proarrhythmic risk of 0.084% per shock (95% upper CL). Conclusions - The Metrix IAD can appropriately detect AF with a high specificity and sensitivity and reliably synchronize within a suitable R wave for shock delivery to minimize the risk of ventricular proarrhythmia.
Persistent Identifierhttp://hdl.handle.net/10722/49087
ISSN
2015 Impact Factor: 17.047
2015 SCImago Journal Rankings: 7.853
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTse, HFen_HK
dc.contributor.authorLau, CPen_HK
dc.contributor.authorSra, JSen_HK
dc.contributor.authorCrijns, HJGMen_HK
dc.contributor.authorEdvardsson, Nen_HK
dc.contributor.authorKacet, Sen_HK
dc.contributor.authorWyse, DGen_HK
dc.date.accessioned2008-06-12T06:34:08Z-
dc.date.available2008-06-12T06:34:08Z-
dc.date.issued1999en_HK
dc.identifier.citationCirculation, 1999, v. 99 n. 11, p. 1446-1451en_HK
dc.identifier.issn0009-7322en_HK
dc.identifier.urihttp://hdl.handle.net/10722/49087-
dc.description.abstractBackground - The long-term efficacy of atrial fibrillation (AF) detection and R-wave synchronization are critical safety requirements for the development of an implantable atrial defibrillator (IAD) for treatment of AF. Methods and Results - The long-term efficacy of the Metrix IAD for AF detection and R-wave synchronization was tested in 51 patients. The mean duration of follow-up was 259 ± 138 days (72 to 613 days). AF detection tests were performed 2240 times during observed operation with 100% specificity and 92.3% sensitivity for differentiation between sinus rhythm and AF; 2219 episodes and their electrograms stored in the device during AF detection were analyzed. The positive predictive value of the AF detection algorithm was 97.4% (lower 95% confidence limit [CL], 94.5%) in the out-of- hospital setting. A total of 242 435 R waves were analyzed for R-wave synchronization. Of these, 49% were marked for synchronized shock delivery, 82% of sinus rhythm and 36% of AFR waves, respectively. All shock markers were properly synchronized and within the R wave (overall synchronization accuracy, 100%; lower 95% CL, 99.999%). Overall, 3719 shocks have been delivered via the IAD with no instance of unsynchronized shock delivery or any episode of proarrhythmia. The observed proarrhythmic risk was 0%, with an estimated maximum proarrhythmic risk of 0.084% per shock (95% upper CL). Conclusions - The Metrix IAD can appropriately detect AF with a high specificity and sensitivity and reliably synchronize within a suitable R wave for shock delivery to minimize the risk of ventricular proarrhythmia.en_HK
dc.format.extent420 bytes-
dc.format.mimetypetext/html-
dc.languageengen_HK
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://circ.ahajournals.orgen_HK
dc.relation.ispartofCirculationen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subjectAtriumen_HK
dc.subjectDefibrillationen_HK
dc.subjectFibrillationen_HK
dc.subjectHeart-assist deviceen_HK
dc.titleAtrial fibrillation detection and R-wave synchronization by metrix implantable atrial defibrillator: Implications for long-term efficacy and safetyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0009-7322&volume=99&issue=11&spage=1446&epage=1451&date=1999&atitle=Atrial+fibrillation+detection+and+R-wave+synchronization+by+Metrix+implantable+atrial+defibrillator:+implications+for+long-term+efficacy+and+safetyen_HK
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_HK
dc.identifier.authorityTse, HF=rp00428en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.pmid10086968-
dc.identifier.scopuseid_2-s2.0-0033596875en_HK
dc.identifier.hkuros40400-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0033596875&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume99en_HK
dc.identifier.issue11en_HK
dc.identifier.spage1446en_HK
dc.identifier.epage1451en_HK
dc.identifier.isiWOS:000079179700011-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridTse, HF=7006070805en_HK
dc.identifier.scopusauthoridLau, CP=7401968501en_HK
dc.identifier.scopusauthoridSra, JS=7005469616en_HK
dc.identifier.scopusauthoridCrijns, HJGM=36079203000en_HK
dc.identifier.scopusauthoridEdvardsson, N=7006610174en_HK
dc.identifier.scopusauthoridKacet, S=7007135828en_HK
dc.identifier.scopusauthoridWyse, DG=7006046340en_HK

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