The confirmation algorithm of implantable cardioverter-defibrillators (ICDs) functioning in the uncommitted mode verifies the presence of a continuing tachyarrhythmia during or following charging of the capacitor. Confirmation is usually applied in relation to the first shock. The details of the normal reconfirmation process of St. Jude ICDs and its role in delayed shock delivery or other abnormalities have received relatively little attention. This review describes the confirmation process of St. Jude ICDs and provides an illustrative clinical example of delayed shock as a result of a pacing or sensing lead fracture. The fundamental timing cycles of St. Jude ICDs are also reviewed to facilitate understanding of the problems related to the confirmation process.
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Machine learning for prediction of ventricular arrhythmia episodes from intracardiac electrograms of automatic implantable cardioverter-defibrillators.
Heart Rhythm
November 2024
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
Background: Despite effectiveness of the implantable cardioverter-defibrillator (ICD) in saving patients with life-threatening ventricular arrhythmias (VAs), the temporal occurrence of VA after ICD implantation is unpredictable.
Objective: The study aimed to apply machine learning (ML) to intracardiac electrograms (IEGMs) recorded by ICDs as a unique biomarker for predicting impending VAs.
Methods: The study included 13,516 patients who received Biotronik ICDs and enrolled in the CERTITUDE registry between January 1, 2010, and December 31, 2020.
Association between QRS shortening and mortality after cardiac resynchronization therapy: Results from the DANISH study.
Int J Cardiol
March 2024
Department of Cardiology, The Heart Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark. Electronic address:
Article Synopsis
- The study aimed to determine the relationship between changes in QRS duration (∆QRS) after cardiac resynchronization therapy (CRT) and mortality rates among patients with heart failure from the DANISH study.
- Researchers analyzed data from 572 patients and found that while there was a slight reduction in all-cause mortality associated with shorter QRS durations, this association vanished after adjusting for other factors.
- The conclusion indicated that in patients with non-ischemic cardiomyopathy, a reduction in QRS duration after CRT did not correlate with improved long-term survival.
Etiologies, Mechanisms, Management, and Outcomes of Electrical Storm.
J Intensive Care Med
February 2024
Section of Electrophysiology, Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA.
Electrical storm (ES) is characterized by three or more discrete sustained ventricular tachyarrhythmia episodes occurring within a limited time frame (generally ≤ 24 h) or an incessant ventricular tachyarrhythmia lasting > 12 h. In patients with an implantable cardioverterdefibrillator (ICD), ES is defined as three or more appropriate device therapies, separated from each other by at least 5 min, which occur within a 24-h period. ES may constitute a medical emergency, depending on the number arrhythmic episodes, their duration, the type, and the cycle length of the ventricular arrhythmias, as well as the underlying ventricular function.
View Article and Find Full Text PDFSubcutaneous implantable cardioverter defibrillator for spontaneous coronary artery dissection with ventricular fibrillation: A report of two cases.
J Cardiol Cases
October 2022
Department of Cardiology, Yokohama Rosai Hospital, Yokohama, Japan.
Unlabelled: The efficacy of implantable cardioverter defibrillators (ICDs) for secondary prevention in spontaneous coronary artery dissection (SCAD) with ventricular fibrillation (VF) remains unclear. Herein, we report two cases of SCAD. In both cases, VF and ST-elevation myocardial infarction (STEMI) were noted, which were previously reported to increase the risk of VF recurrence and sudden cardiac death (SCD).
View Article and Find Full Text PDFA new prediction model for ventricular arrhythmias in arrhythmogenic right ventricular cardiomyopathy.
Eur Heart J
August 2022
Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Carnegie 568D, 600 N. Wolfe St. Baltimore, MD, USA.
Aims: Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVC) is characterized by ventricular arrhythmias (VAs) and sudden cardiac death (SCD). We aimed to develop a model for individualized prediction of incident VA/SCD in ARVC patients.
Methods And Results: Five hundred and twenty-eight patients with a definite diagnosis and no history of sustained VAs/SCD at baseline, aged 38.
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