P-wave evidence as a method for improving algorithm to detect atrial fibrillation in insertable cardiac monitors.
Heart Rhythm
; 11(9): 1575-83, 2014 Sep.
Article
en En
| MEDLINE
| ID: mdl-24912139
ABSTRACT
BACKGROUND:
Frequent premature atrial contractions and sick sinus syndrome are primary causes of inappropriate atrial fibrillation (AF) detection in insertable cardiac monitors (ICMs).OBJECTIVE:
The study aimed to validate an algorithm designed to reduce inappropriate AF detection on the basis of the identification of a single P wave during the cardiac cycle.METHODS:
The original detection algorithm looks for evidence of AF based on differences in the pattern of R-R intervals over a 2-minute period. The improved algorithm reduces evidence for AF detection if P waves are detected. The algorithm was validated by using Holter data, which collected 2 leads of surface electrocardiogram and continuously uplinked ICM electrocardiogram over a 46-hour period. ICM detections were compared with Holter annotations to compute episode and duration detection performance.RESULTS:
Valid Holter recordings (8442 hours) were analyzed from 206 patients. True AF was observed in 76 patients, yielding 482 true AF episodes ≥2 minutes in duration and 1191 hours of AF. The algorithm correctly identified 97.8% of the total AF duration and 99.3% of the total sinus or non-AF rhythm duration. The algorithm detected 85% (90% per-patient average) of all AF episodes ≥2 minutes in duration, and 55% (78% per-patient average) of the detected episodes had AF. AF was found in 95% of the detected episodes >1 hour. The improved algorithm reduced inappropriate episodes and duration by 46% and 55%, respectively, while also reducing appropriate episodes and duration by 2% and 0.1%, respectively.CONCLUSION:
An improvement in the ICM algorithm for AF detection incorporating P-wave information substantially reduced inappropriately detected episodes and duration, with minimal reduction in sensitivity for detecting AF.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Fibrilación Atrial
/
Algoritmos
/
Sistemas de Computación
/
Diagnóstico por Computador
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Electrocardiografía Ambulatoria
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
Límite:
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Heart Rhythm
Año:
2014
Tipo del documento:
Article