Detection of @entity955 and flutter by a dual-chamber @entity737 . For the Worldwide Jewel XXXX Investigators.

@entity1 @entity5748 @entity737 @entity591 @entity955 @entity943 @entity7129
BACKGROUND: To distinguish prolonged episodes of @entity955 ( @entity955 ) that require cardioversion from self-terminating episodes that do not, an @entity955 ( @entity737 ) must be able to detect @entity955 continuously for extended periods. The @entity737 should discriminate between @entity591 ( @entity591 ), which may be terminated by antitachycardia pacing, and @entity955 , which requires cardioversion. METHODS AND RESULTS: We studied 80 @entity1 with @entity591 / @entity955 and @entity943 who were treated with a new @entity5748 . During a follow-up period lasting 6+/-2 months, we validated spontaneous, device-defined @entity591 / @entity955 episodes by stored electrograms in all @entity1 . In 58 @entity1 , we performed 80 Holter recordings with telemetered atrial electrograms, both to validate the continuous detection of @entity591 / @entity955 and to determine the sensitivity of the detection of @entity591 / @entity955 . Detection was appropriate in 98% of 132 @entity955 episodes and 88% of 190 @entity591 episodes (98% of 128 @entity591 episodes with an atrial cycle length <300 ms). Intermittent sensing of far-field R waves during @entity7129 caused 27 inappropriate @entity591 / @entity955 detections; these detections lasted 2.6+/-2.0 minutes. @entity591 / @entity955 was detected continuously in 27 of 28 @entity1 who had spontaneous episodes of @entity591 / @entity955 (96%). The device memory recorded 90 appropriate @entity591 / @entity955 episodes lasting >1 hour, for a total of 2697 hours of continuous detection of @entity591 / @entity955 . During Holter monitoring, the sensitivity of the detection of @entity591 / @entity955 (116 hours) was 100%; the specificity of the detection of non- @entity591 / @entity955 rhythms (1290 hours) was 99.99%. Of 166 appropriate episodes detected as @entity591 , 45% were terminated by antitachycardia pacing. CONCLUSIONS: A new @entity737 detects @entity591 / @entity955 accurately and continuously. Therapy may be programmed for long-duration @entity591 / @entity955 , with a low risk of underdetection. Discrimination of @entity591 from @entity955 permits successful pacing therapy for a significant fraction of @entity591 .
