How does the ICD recognize the type of arrhythmia? Tachyarrhythmia discrimination in modern transvenous cardioverter defibrillators

• 出版年: Cardiologia Hungarica
• 主要な著者: Flóra Diána Gausz, Zsolt Bári, Máté Vámos
• フォーマット: 論文
• 言語: 英語
• 出版事項: Promenade Kft 2025-08-01
• 主題: icd; implantable cardioverter defibrillator; tachyarrhytmia discrimination; discriminator algorithm; icd programming
• オンライン･アクセス: https://cardiologia.hungarica.eu/archive/2025-issues/2025-4-contents/how-does-the-icd-recognize-the-type-of-arrhythmia-tachyarrhythmia-discrimination-in-modern-transvenous-cardioverter-defibrillators
• ISSN: 0133-5596; 1588-0230

Modern cardioverter defibrillators apply different discrimination algorithms to differentiate between supraventricular arrhythmias and malignant ventricular arrhythmias, leading to a decrease in the rate of inappropriate ICD therapies. The two main groups of discrimination algorithms are single-chamber and dual-chamber configurations. Single-chamber discriminators analyze only ventricular signals, while dual-chamber algorithms evaluate both ventricular and atrial activity. While different ICD devices distinguish between arrhythmias based on fundamentally similar criteria, the several various, manufacturer-based programming options allow for several configurable discrimination settings. The aim of this review article is to describe the essential single- and dual-chamber discrimination algorithms, emphasizing the main differences between the most commonly used devices nowadays in Hungary.