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Analysis of implantable cardioverter defibrillator signals for non conventional cardiac electrical activity characterization

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Abstract

Implantable cardioverter defibrillators (ICDs) can store intracardiac electrograms (EGMs) in sinus rhythm (SR), at the onset of spontaneous ventricular tachyarrhythmias (VT) or during their course. This allows the investigation of unknown features of the heart electrical activity associated with different cardiac rhythms. In this study we propose a non conventional cardiac electrical activity characterization (CEAC) that extracts quantitative information about the power spectrum wideness and variability of the beat-by-beat morphology. We analyze 293 EGMs from 40 patients who underwent implantation of St Jude Medical–Ventritex ICDs that allow the storage of EGMs with two different modes of recording: bipolar (BIP) and unipolar or far-field (FF). The EGMs are studied with this CEAC by (1) exploring differences between the CEAC measured from FF and BIP EGMs during similar cardiac rhythms, and (2) investigating the mode of recording that allows a better separation between SR and VT rhythms. Results show that, with similar cardiac rhythm, the CEACs from FF or BIP recordings are different (for SR rhythm: sensitivity 81.5%, specificity 93.6%; for VT rhythm: sensitivity and specificity 100%); thus FF and BIP EGMs analyze different aspects of cardiac activity.The CEAC applied to FF EGMs distinguishes better EGMs obtained during SR from VT rhythms (VT vs SR with sensitivity 92.7% and specificity 79.7%) than when it is applied to BIP signals (VT vs SR with sensitivity 60% and specificity 73.3%).

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Acknowledgements

The authors are very grateful to Josh Reiss from St Jude Medical – Sunny Vale for his comments on this paper and to Stella De Robertis for English language assistance. We also like to thank Prof. Sergio Chierchia for his helpful comments and Dr Roberto Mureddu, Dr Edoardo Casali, and Dr Natale di Belardino for their help in recruiting electrograms during the early stage of the study.

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Authors and Affiliations

  1. Institute of Biophysics, National Research Council, Via De Marini 6, 16149, Genova, Italy

    Aldo Casaleggio

  2. Cardiology Division, San Martino Hospital, Genova, Italy

    Paolo Rossi & Giuseppe Sartori

  3. St. Jude Medical Italia, Agrate Brianza, Milano, Italy

    Andrea Faini & Tiziana Guidotto

  4. Cardiology Division, Policlinico di Modena, Modena, Italy

    Vincenzo Malavasi

  5. Cardiology Division, Imperia Hospital, Imperia, Italy

    Giacomo Musso

Authors
  1. Aldo Casaleggio
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  2. Paolo Rossi
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  3. Andrea Faini
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  4. Tiziana Guidotto
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  5. Vincenzo Malavasi
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  6. Giacomo Musso
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  7. Giuseppe Sartori
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Correspondence to Aldo Casaleggio.

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Casaleggio, A., Rossi, P., Faini, A. et al. Analysis of implantable cardioverter defibrillator signals for non conventional cardiac electrical activity characterization. Med Bio Eng Comput 44, 45–53 (2006). https://doi.org/10.1007/s11517-005-0014-0

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  • DOI: https://doi.org/10.1007/s11517-005-0014-0

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