SICD

Question 1

Identify the 3 phase structure of the SICD Insight Algorithm

Answer 1

Phase I - detection
Phase II - Certification
Phase III - Therapy decision

Question 2

How does the subcutaneous signal compare to surface or transvenous?

Answer 2

SICD - Far field sensing similar to surface ECG

S-ECG has 41 points on QRS
TV-ICD has 8 points on QRS

Question 3

How does S-CD sensing compare to TV-ICD?

Answer 3

TVICD - optimized for beat sensitivity or specificity
SICD - optimized for rhythm sensitivity and specificity

Question 4

Explain phase 1 of SICD sensing and detection

Answer 4

Detection - signal filtered and detections identified

3 filters applied = sensing profile selected for signal detection

Question 5

Explain phase 2 of SICD sensing and detection

Answer 5

Certification - Certified heart rate determined

N and dot markers generated

Question 6

Explain phase 3 of SICD sensing and detection

Answer 6

Therapy decision - Rhythm assess and therapy confirmed

S and T markers generated

Question 7

What 3 filters are used during phase 1 (detection)

Answer 7

Band pass
Notch filter
SMART pass filter

Question 8

Identify the stages within Phase I (detection)

Answer 8

1. S-ECG
2. Signal filtering
3. Signal Detection
   Phase 2: Certification

Question 9

What is the criteria for ambulatory deactivation of SMART pass filter?

Answer 9

5 contiguous amplitude measurements of <0.25mV
10s of Asystole
Bradycardia

Question 10

Identify the 5 detection/sensing profiles

Answer 10

Fast profile
Mid rate 2 profile
Mid rate 1 profile
2 slow rate profiles

Question 11

Explain the fast profile

Answer 11

Fast profile: used in shock zone. Aggressive sensing for low amplitude, fast rhythms

Question 12

Explain the Mid rate 2 profile

Answer 12

Mid rate 2: Used in conditional zone. For MVT and BBB - wide morphologies and mid rate

Question 13

Explain the Mid rate 1 profile

Answer 13

Mid rate 1: Between 170bpm and conditional zone. For MVT and BBB - wide morphologies and mid rate

Question 14

Explain the 2 slow rate profiles

Answer 14

2 slow rate: Below 170bpm. Accurate NSR sensing

Question 15

How is the sensing/detection profile adjusted?

Answer 15

Baste on the rate of the certified incoming signals, the SICD will adjust the detection profile, to further optimize sensing

Question 16

What is the purpose of the certification phase?

Answer 16

Certifies that detections are cardiac in nature and calculates accurate heart rate