Arrhythmia discrimination using hemoglobin spectroscopy in humans

Compton, Steven J.; Swerdlow, Charles D.; Canby, Robert C.; Strobel, Günther; Zagrodzky, Jason; Cinbis, Can; Carney, J.; Bhunia, Sourav K.

doi:10.1016/j.hrthm.2012.05.003

Cited by 5 publications

(9 citation statements)

References 14 publications

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“…(Once VF has persisted for sufficient time, these methods, however, should eventually recognize lack of perfusion, as found by Compton et al. (12).) Our study, which incorporates electromechanical coupling quantification, means a confident automated diagnosis can be reached quickly.…”

Section: Discussionmentioning

confidence: 65%

“…The running mean (12) method aims to reduce the impact of noise by averaging a number of beats and comparing this to a reference. However, variables such as laser Doppler flow vary enormously among individuals and over time, so there is no global threshold that can be applied uniformly.…”

Section: Discussionmentioning

confidence: 99%

“…These methods rely on various properties of reflected light rather than on a pressure sensor inside the blood stream. Some studies have previously been conducted to investigate an approach for augmenting ICD discrimination 12, 13, 14, 15.…”

Section: Methodsmentioning

confidence: 99%

“…The perfusion data were also analyzed using 2 previously described algorithms. The first algorithm calculates the running mean of the perfusion data over the analytical window (12). The second calculates the mean peak-to-trough height after passing a band-pass filter over the analytical window (the oscillatory height method) 13, 14, 15.…”

Section: Methodsmentioning

confidence: 99%

“…In the running mean approach, an average value for the marker over several seconds is compared to an average value taken from a recent reference time, commonly immediately previously (12). This requires continuous monitoring, which impairs battery longevity.…”

Section: Neither Steady State (Running Mean) Level Nor Oscillatory Hementioning

confidence: 99%

See 4 more Smart Citations

Quantification of Electromechanical Coupling to Prevent Inappropriate Implantable Cardioverter-Defibrillator Shocks

Keene

Shun-Shin

Arnold

et al. 2019

JACC: Clinical Electrophysiology

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Objectives This study sought to test specialized processing of laser Doppler signals for discriminating ventricular fibrillation (VF) from common causes of inappropriate therapies. Background Inappropriate implantable cardioverter-defibrillator (ICD) therapies remain a clinically important problem associated with morbidity and mortality. Tissue perfusion biomarkers, implemented to assist automated diagnosis of VF, sometimes mistake artifacts and random noise for perfusion, which could lead to shocks being inappropriately withheld. Methods The study tested a novel processing algorithm that combines electrogram data and laser Doppler perfusion monitoring as a method for assessing circulatory status. Fifty patients undergoing VF induction during ICD implantation were recruited. Noninvasive laser Doppler and continuous electrograms were recorded during both sinus rhythm and VF. Two additional scenarios that might have led to inappropriate shocks were simulated for each patient: ventricular lead fracture and T-wave oversensing. The laser Doppler was analyzed using 3 methods for reducing noise: 1) running mean; 2) oscillatory height; and 3) a novel quantification of electromechanical coupling which gates laser Doppler relative to electrograms. In addition, the algorithm was tested during exercise-induced sinus tachycardia. Results Only the electromechanical coupling algorithm found a clear perfusion cut off between sinus rhythm and VF (sensitivity and specificity of 100%). Sensitivity and specificity remained at 100% during simulated lead fracture and electrogram oversensing. (Area under the curve running mean: 0.91; oscillatory height: 0.86; electromechanical coupling: 1.00). Sinus tachycardia did not cause false positive results. Conclusions Quantifying the coupling between electrical and perfusion signals increases reliability of discrimination between VF and artifacts that ICDs may interpret as VF. Incorporating such methods into future ICDs may safely permit reductions of inappropriate shocks.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%