Full Access
Biosensor Applications to Antitachycardia Devices
TODD J. COHEN,
L. BING LIEM,
Corresponding Author
TODD J. COHEN
Arrhythmia Unit, Cardiology Division, Stanford University Medical Center, Stanford, California
Address for reprints: Todd J. Cohen. M.D., Room 312, Moffitt Hospital, Box 0214, University of California, San Francisco, CA 94143.Search for more papers by this authorL. BING LIEM
Arrhythmia Unit, Cardiology Division, Stanford University Medical Center, Stanford, California
Search for more papers by this authorTODD J. COHEN,
L. BING LIEM,
Corresponding Author
TODD J. COHEN
Arrhythmia Unit, Cardiology Division, Stanford University Medical Center, Stanford, California
Address for reprints: Todd J. Cohen. M.D., Room 312, Moffitt Hospital, Box 0214, University of California, San Francisco, CA 94143.Search for more papers by this authorL. BING LIEM
Arrhythmia Unit, Cardiology Division, Stanford University Medical Center, Stanford, California
Search for more papers by this authorAbstract
Current arrhythmia detection algorithms are unable to adequately distinguish stable from unstable tachycardias; therefore application of a biosensor to antitachycardia devices has been proposed to improve their performance, Right heart pressures and impedance have been investigated for incorporation into these systems. Integration of other parameters (oxygen saturation, preejection period, pH, cardiac output, flow, and temperature) into these devices might also prove useful. The status of these biosensor arrhythmia detection algorithms and their application to antitachycardia devices are described below.
References
- 1 Mirowski M, Mower M, Staewen W, et al. Standby automatic defibrillator. Arch Intern Meet 1970; 126: 158–161.
- 2 Jenkins J, Wu D, Arzbaecher R. Computer diagnosis of supraventricular and ventricular arrhythmias. Circulation 1979; 60: 977–985.
- 3 Furman S, Fisher JD, Pannizzo F. Necessity of signal processing in tachycardia detection. In SS Barold, J. Mugica (eds.): The Third Decade of Cardiac Pacing. Mt. Kisco , New York , Futura Publishing Co., Inc., 1982, pp. 265–274.
- 4 Mercando AD, Furman S. Measurement of differences in timing and sequence between two ventricular electrodes as a means of tachycardia differentiation. PACE 1986; 9(II): 1069–1078.
- 5 Tomaselli GF, Nielsen AP, Finke WL, et al. Morphologic differences of the endocardial electrogram in beats of sinus and ventricular origin. PACE 1988; 11: 254–262.
- 6 Davies DW, Wainwright RJ, Tooley MA, et al. Detection of pathological tachycardia by analysis of electrogram morphology. PACE 1986; 9: 200–208.
- 7 Langberg JJ, Gibb WJ, Auslander DM, et al. Identification of ventricular tachycardia using the morphology of the endocardial electrogram (abstract). Circulation 1985; 72(Suppl. III): 111–474.
- 8 Cohen TJ. A theoretical right atrial pressure feedback heart rate control system to restore physiologic control to the rae-limited heart. PACE 1984; 7: 671–677.
- 9 Olson WH, Bennett TD, Huberty KP. et al. Automatic detection of ventricular fibrillation with chronically implanted pressure sensors (abstract). J Am CollCardiol 1986; 7: 182A.
- 10 Cohen, TJ, Veltri EP, Lattuca JJ, et al. Hemodynamic responses to rapid pacing: A model for tachycardia differentiation. PACE 1988; 11: 1522–1528.
- 11
Cohen TJ,
Veltri EP,
Mower MM.
A hemodynamically responsive antitachycardia system; Theoretical bases for design.
J| Electrophysiol
1988; 2: 352–358.
10.1111/j.1540-8167.1988.tb01496.x Google Scholar
- 12 Cohen TJ, Liem LB. A hemodynamically responsive antitachycardia system: Development and basis for design in man. Circulation 1990; 82: 394–406.
- 13 Khoury D, McAlister H, Wilkoff B, et al. Continuous right ventricular volume assessment by catheter measurement of impedance for antitachycardia system control. PACE 1989; 12: 1918–1926.
- 14 Sharma AD, Bennett TD, Erikson M, et al. Right ventricular pressure during ventricular arrhythmias in humans: Potential implications for implantable antitachycardia devices. J Am Coll Cardiol 1990; 15: 648–655.
- 15
Ellenbogen KA,
Lu B,
Kapadia K, et al.
Usefulness of right ventricular pulse pressure as a potential sensor for hemodynamically unstable ventricular tachycardia.
Am J Cardiol
1990; 65: 1105–1111.
10.1046/j.1540-8167.2005.40643.x Google Scholar
- 16
Wood MA,
Ellenbogen KA,
Kapadia K, et al.
A prospective comparison of right ventricular impedance, pulse pressure and maximal right ventricular dP/dt to predict the hemodynamic stability of ventricular tachycardia (abstract). PACE
1990; 13: 505.
10.1111/j.1540-8159.1990.tb02173.x Google Scholar
- 17 McGoon MD, Shapland JE, Salo R, et al. The feasibility of utilizing the systolic pre-ejection interval as a determinant of pacing rate. J Am Coll Cardiol 1989: 14: 1753–1758.
- 18 Chirife R, Ortega DF. Sensor controlled implantable cardioverter-defibrillator. Basis for the use of pre-ejection period to discriminate sinus tachycardia from tachyarrhythmia. (abstract) RBM 1990; 12(3): 124.
- 19 Fearnot NE, Smith HJ, Sellers D, et al. Evaluation of the temperature response to exercise testing in patients with single chamber, rate adaptive pacemakers: A multicenter study. PACE 1989; 12: 1806–1815.
- 20 Wirtzfeld A, Goedel-Meinen L, Bock T, et al. Central venous oxygen saturation for the control of automatic rate-responsive pacing. PACE 1982; 5: 829–835.
- 21 Wirtzfeld A, Heinze R, Hoekstein K, et al. Regulation of pacing rate by variations of mixed venous oxygen saturation. PACE 1984; 7: 1257–1262.
- 22 Stangl K, Wirtzfeld A, Heinze R, et al. First clinical experience with an oxygen saturation controlled pacemaker in man. PACE 1988: 11: 1882–1887.
- 23 Stangl K, Wirtzfeld A, Heinz R, et al. First experiences with an oxygen pacemaker in man (abstract). PACE 1990; 13: 560.
- 24 Segal J, Pearl RG, Ford AJ, et al. Instantaneous and continuous cardiac output obtained with a Doppler pulmonary artery catheter, J Am Coll Cardiol 1989; 13: 1382–1392.
- 25 Cammilli L. Initial use of a pH triggered pacemaker. PACE 1989; 12: 1000–1007.
Citing Literature
