Is QRS Duration a Reliable Parameter in Discriminating between Supraventricular and Ventricular Arrhythmias?
Automatic implantable cardioverter defibrillators (ICDs) are designed to detect and terminate ventricular tachyarrhythmias. Ideally, they do so with a high specificity and sensitivity. Actual ICD technology with detection based mainly on rate provides high sensitivity but moderate specificity. This means that ICD therapy can be initiated by rapid supraventricular tachyarrhythmias. These inappropriate therapies consist either of antitachycardia pacing, cardioversion or defibrillation. Antitachycardia pacing for a supraventricular tachycardia can induce ventricular tachyarrhythmias; in the worse case, this can ultimately lead to arrhythmic death . It is recognized by many publications that inappropriate therapy imposes serious limitations to ICD therapy due to the discomfort associated as well as to the possible serious proarrhythmic consequences [2–7, 11].
KeywordsVentricular Tachycardia Implantable Cardioverter Defibrillator Supraventricular Tachycardia Ventricular Tachyarrhythmia Reliable Parameter
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