{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T07:16:46Z","timestamp":1778311006569,"version":"3.51.4"},"reference-count":13,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2005,4,12]],"date-time":"2005-04-12T00:00:00Z","timestamp":1113264000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2005,6]]},"abstract":"<jats:p> <jats:italic>Background:<\/jats:italic> Inappropriate shocks from implantable cardioverter defibrillators (ICD) remain a significant clinical problem despite device discrimination algorithms. The atrial response to antitachycardia pacing (ATP) may determine the mechanism of 1:1 A:V tachycardia.<\/jats:p><jats:p> <jats:italic>Methods:<\/jats:italic> For this study we refer to sinus tachycardia, atrial tachycardia (AT), atrial fibrillation, and flutter as atrial tachycardia (AT), and all other tachycardia as \u201cnon\u2010AT.\u201d Three atrial response patterns during the burst of ATP were determined. The atrial cycle length (ACL) may be unchanged (type 1) indicating AT. The ACL may show variation during ATP (type 2) indicating variable VA block and does not discriminate between an AT and a non\u2010AT mechanism, in which case a default diagnosis of non\u2010AT is made. The ACL may accelerate to the ATP cycle length (type 3) indicating entrainment. A VAAV response at the end of ATP was considered diagnostic of AT (type 3A) whereas a VAV or VVA response was considered a non\u2010AT mechanism (type 3B). This algorithm was applied to ICD tracings from 68 episodes of spontaneous 1:1 A:V tachycardia that had 136 sequences of ATP administered. The rhythm \u201ctruth\u201d was determined by consensus of two experienced clinicians.<\/jats:p><jats:p> <jats:italic>Results:<\/jats:italic> The algorithm correctly identified AT with a sensitivity of 71.9% (95% CI: 67.1\u201373.6), and specificity of 95% (83.5\u201399.1). The PPV was 97.2% (90.9\u201399.5), and NPV 58.5% (51.4\u201361.0). Kappa was 0.57 (0.43\u20130.62). If used clinically the algorithm would have aborted 53.3% (8\/15) of inappropriate shocks delivered into an AT\u2010mechanism tachycardia and would not have withheld a shock for any episode of VT.<\/jats:p><jats:p> <jats:italic>Conclusion:<\/jats:italic> Analysis of atrial response patterns during and after ventricular ATP can successfully discriminate tachycardia mechanism and may reduce inappropriate ICD shocks.<\/jats:p>","DOI":"10.1046\/j.1540-8167.2005.40474.x","type":"journal-article","created":{"date-parts":[[2005,6,9]],"date-time":"2005-06-09T09:09:11Z","timestamp":1118308151000},"page":"601-605","source":"Crossref","is-referenced-by-count":21,"title":["Atrial Response to Ventricular Antitachycardia Pacing Discriminates Mechanism of 1:1 Atrioventricular Tachycardia"],"prefix":"10.1111","volume":"16","author":[{"given":"DARYL P.","family":"RIDLEY","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"LORNE J.","family":"GULA","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ANDREW D.","family":"KRAHN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ALLAN C.","family":"SKANES","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"RAYMOND","family":"YEE","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MARK L.","family":"BROWN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"WALTER H.","family":"OLSON","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JEFFREY M.","family":"GILLBERG","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"GEORGE J.","family":"KLEIN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2005,4,12]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eupc.2003.09.007"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1540-8167.2001.00134.x"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.2003.t01-1-00168.x"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2003.00361.x"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1540-8167.2003.01554.x"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.2001.00835.x"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1540-8167.2000.01196.x"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1540-8167.2003.02285.x"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2003.00359.x"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(00)00770-1"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1540-8167.2001.00606.x"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.97.1.66"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.103.3.381"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1046%2Fj.1540-8167.2005.40474.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1046\/j.1540-8167.2005.40474.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T03:30:09Z","timestamp":1696995009000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1046\/j.1540-8167.2005.40474.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,4,12]]},"references-count":13,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2005,6]]}},"alternative-id":["10.1046\/j.1540-8167.2005.40474.x"],"URL":"https:\/\/doi.org\/10.1046\/j.1540-8167.2005.40474.x","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,4,12]]}}}