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Distinct spectral dynamics of implanted cardiac defibrillator signals in spontaneous termination of polymorphic ventricular tachycardia and fibrillation in patients with electrical and structural diseases.

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2022

Authors

Calvo, David
Salinas, Lucia
Martínez-Camblor, Pablo
García-Iglesias, Daniel
Alzueta, Javier
Rodríguez, Anibal
Romero, Rafael
Viñolas, Xavier
Fernández-Lozano, Ignacio
Anguera, Ignasi

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Abstract

To determine the spectral dynamics of early spontaneous polymorphic ventricular tachycardia and ventricular fibrillation (PVT/VF) in humans. Fifty-eight self-terminated and 173 shock-terminated episodes of spontaneously initiated PVT/VF recorded by Medtronic implanted cardiac defibrillators (ICDs) in 87 patients with various cardiac pathologies were analyzed by short fast Fourier transform of shifting segments to determine the dynamics of dominant frequency (DF) and regularity index (RI). The progression in the intensity of DF and RI accumulations further quantified the time course of spectral characteristics of the episodes. Episodes of self-terminated PVT/VF lasted 8.6 s [95% confidence interval (CI): 8.1-9.1] and shock-terminated lasted 13.9 s (13.6-14.3) (P Consistent with the notion that fast organized sources maintain PVT/VF in humans, reduction of frequency and regularity correlates with early self-termination. Our findings might help generate ICD methods aiming to reduce inappropriate shock deliveries.

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Humans
Defibrillators, Implantable
Tachycardia, Ventricular
Arrhythmias, Cardiac
Ventricular Fibrillation

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Keywords

Polymorphic ventricular tachycardia • Ventricular fibrillation • Implanted cardiac defibrillators • Arrhythmogenic substrate • Spectral analysis • Dominant frequency • Regularity index

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