• 전기전자학회논문지
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• 제5권2호
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• pp.182-189
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• 2001

Single-pass VDD 심장 박동기(pacemaker)는 하나의 리드만 이식하는 수술 과정의 단순함과 하나의 리드만으로 심방 탈분극파를 적절히 검출하여 심방-심실 탈분극의 연속성(A-V sequence)을 이를 수 있다는 이유로 널리 사용되고 있으나, 검출의 신뢰도에 대해서는 여전히 논의의 대상이 되고 있다. 본 논문에서는 논의의 대상이 되고 있는 심방 탈분극파 검출을 개선하기 위하여 자동화된 심장 박동기 심파 검출 알고리즘을 9명의 환자로부터 얻은 Single-pass VDD 심파에 적용하고, 실제 심파 검출과정에서의 동작 특성을 관찰하였다. 자동화된 검출 알고리즘은 최근에 검출된 두 개의 intrinsic 탈분극파 진폭의 평균치를 계산하여 그 평균치의 50%로 검출 문턱치를 매 박동마다 조정하는 매우 단순한 방법으로, 자동화된 검출 알고리즘의 핵심인 문턱 전압 검출치의 자동적 조정만으로도 Single-pass VDD 심방 탈분극파 검출을 개선할 수 있음을 확인하였다.

• 대한의용생체공학회:의공학회지
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• 제23권6호
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• pp.477-484
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• 2002

A pacemaker autosense algorithm with dual thresholds. one for noise or tachyarrhythmia detection (noise threshold, NT) and the other for intrinsic beat detection (sensing threshold. ST), was developed to improve the sensing performance in single pass VDD electrograms. unipolar electrograms, or atrial fibrillation detection. When a deflection in an electrogram exceeds the NT (defined as 50% of 57), the autosense algorithm with dual thresholds checks if the deflection also exceeds the ST. If it does, the autosense algorithm calculates the signal to noise ratio (SNR) of the deflection to the highest deflection detected by NT but lower than ST during the last cardiac cycle. If the SNR 2, the autosense algorithm declares an intrinsic beat detection and calculates the next ST based on the three most recent intrinsic peaks. If the SNR $\geq$2, the autosense algorithm checks the number of deflections detected by NT during the last cardiac cycle in order to determine if it is a noise detection or tachyarrhythmia detection. Usually the autosense algorithm tries to set the 57 at 37.5% of the average of the three intrinsic beats, although it changes the percentage according to event classifications. The autosense algorithm was tested through computer simulation of atrial electrograms from 5 patients obtained during EP study, to simulate a worst sensing situation. The result showed that the ST levels for autosense algorithm tracked the electrogram amplitudes properly, providing more noise immunity whenever necessary. Also, the autosense algorithm with dual thresholds achieved sensing performance as good as the conventional fixed sensitivity method that was optimized retrospectively.

• 대한전자공학회:학술대회논문집
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• 대한전자공학회 1999년도 하계종합학술대회 논문집
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• pp.1063-1066
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• 1999

The delay of cardiac depolarization wave detection in the conventional pacemakers or AICD (automatic implantable cardioverter/ defibrillator, or ICD) has been overlooked. However, it is known that the delay may cause hemodynamic problems and may prevent the proper operation of a new automatic feature, automatic capture verification, that is to be appeared in the near-future devices. In order to reduce the effects of the delay, a delay prevention algorithm was developed and tested by applying three human electrograms. The algorithm set the sensing threshold just above the measured noise level to reduce the detection delay. It is found that the low threshold was able to reduce the delay by 20msec(average) In most cases. The implementation results showed reliability and efficacy of the algorithm, and the algorithm could be applicable to the existing hardware and software of the conventional pacemakers and AICD without any significant modifications.