Interactive Simulator for Evaluating the Detection Algorithms of Implantable Defibrillators

Summary Despite sophisticated implantable cardioverter-defibrillator (ICD) detection algorithms, inappropriate therapy for supraventricular tachyarrhythmias is still a common problem. A comparison of detection algorithms based on the specificity to detect supraventricular tachyarrhythmias reported from different clinical studies is of a limited value because the spectrum of tachyarrhythmias recorded during these studies may vary substantially. In addition, the values of specificity derived from simulations performed by each manufacturer separately do not allow a correct comparison of the performance of different detection algorithms unless the database of tachyarrhythmias is uniform for all devices compared. Based on tachyarrhythmias recorded during electrophysiological study, we created a database including supraventricular and ventricular tachyarrhythmias that may serve as such a uniform database for direct comparison of all available ICD detection algorithms. By customizing a simulator, we created a fully interactive device compatible with all ICDs via standard connectors that may serve as a uniform platform to evaluate and compare ICD detection algorithms. In addition, it is a valuable tool for selecting the optimum ICD for a patient with a specific spectrum of arrhythmias and training physicians.