如何减少ICD的不适当放电课件_2.pptVIP

双腔ICD----PR Logic 基本运算指标: 频率 (AV) 模式 (AV 关系) 规律性 (心室) 房室分离 远场R波感知 * * * * . * * * * EGM Width is an exclusive, advanced detection algorithm offered in the Medtronic Micro Jewel?II device. If questioned about PDF: EGM Width is NOT like PDF. Probability Density Function (PDF) is a feature that was available in the early CPI devices. PDF does not assess individual waveform morphology PDF is not tied to sensed events PDF is based on a mathematical model that uses signal amplitude Clinical results show the feature to be ineffective in distinguishing SVTs from VTs. The EGM Width Criterion is a programmable option intended to reduce inappropriate therapies due to rapidly conducted sinus tachycardia, atrial fibrillation, or atrial flutter. The EGM Width Criterion provides dual chamber discrimination in a single chamber ICD. The EGM Width Criterion was tested as part of the clinical study for the Model 7218 ICD. The clinical findings report VT detection specificity increased to 88%, VT detection sensitivity was maintained at 98%, and 18% of detected VT episodes were appropriately rejected as SVT with the use of EGM Width Criterion. The Passive mode allows measurement and storage of the width of the QRS complexes but is not used as a criterion for detection. * * Problem: Cautery can be detected by the ICD and produce inappropriate detection. Possible Symptoms: Over-detection. Non-sustained episodes recorded. Acute/Chronic: Either Definitive Diagnostics: Episode records, Patient Interview. Solution: A physician may choose to have the detections or therapy of an ICD turned off, or suspended, during a procedure that requires the use of electrocautery. It is emphasized that when this is done it is very important that detection or therapy be turned back on post-op. Note: In Medtronic devices, a magnet may be applied over a device to temporarily suspend detection for as long as the magnet is over the device. As soon as the magnet is removed, detection resumes as