{"id":701,"date":"2025-07-31T14:10:19","date_gmt":"2025-07-31T14:10:19","guid":{"rendered":"https:\/\/cardiocases.com\/?page_id=701"},"modified":"2025-11-16T17:07:58","modified_gmt":"2025-11-16T17:07:58","slug":"discrimination-boston-scientific","status":"publish","type":"page","link":"https:\/\/cardiocases.com\/fr\/pacing-defibrillation\/devices-per-company\/boston-scientific\/discrimination-boston-scientific\/","title":{"rendered":"Discrimination Boston Scientific"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"701\" class=\"elementor elementor-701\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-60c792f e-flex e-con-boxed e-con e-parent\" data-id=\"60c792f\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8e8f283 elementor-widget elementor-widget-heading\" data-id=\"8e8f283\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Boston Scientific - Discrimination<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-abef9a8 elementor-toc--minimized-on-tablet elementor-widget elementor-widget-table-of-contents\" data-id=\"abef9a8\" data-element_type=\"widget\" data-settings=\"{&quot;headings_by_tags&quot;:[&quot;h3&quot;,&quot;h4&quot;,&quot;h5&quot;],&quot;exclude_headings_by_selector&quot;:[],&quot;no_headings_message&quot;:&quot;No headings were found on this page.&quot;,&quot;marker_view&quot;:&quot;bullets&quot;,&quot;icon&quot;:{&quot;value&quot;:&quot;fas fa-circle&quot;,&quot;library&quot;:&quot;fa-solid&quot;,&quot;rendered_tag&quot;:&quot;&lt;svg class=\\&quot;e-font-icon-svg e-fas-circle\\&quot; viewBox=\\&quot;0 0 512 512\\&quot; xmlns=\\&quot;http:\\\/\\\/www.w3.org\\\/2000\\\/svg\\&quot;&gt;&lt;path d=\\&quot;M256 8C119 8 8 119 8 256s111 248 248 248 248-111 248-248S393 8 256 8z\\&quot;&gt;&lt;\\\/path&gt;&lt;\\\/svg&gt;&quot;},&quot;minimize_box&quot;:&quot;yes&quot;,&quot;minimized_on&quot;:&quot;tablet&quot;,&quot;hierarchical_view&quot;:&quot;yes&quot;,&quot;min_height&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;min_height_tablet&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;min_height_mobile&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]}}\" data-widget_type=\"table-of-contents.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-toc__header\">\n\t\t\t\t\t\t<h4 class=\"elementor-toc__header-title\">\n\t\t\t\tG\u00e9n\u00e9ralit\u00e9s\t\t\t<\/h4>\n\t\t\t\t\t\t\t\t\t\t<div class=\"elementor-toc__toggle-button elementor-toc__toggle-button--expand\" role=\"button\" tabindex=\"0\" aria-controls=\"elementor-toc__abef9a8\" aria-expanded=\"true\" aria-label=\"Ouvrir la table des mati\u00e8res\"><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-down\" viewbox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M207.029 381.476L12.686 187.132c-9.373-9.373-9.373-24.569 0-33.941l22.667-22.667c9.357-9.357 24.522-9.375 33.901-.04L224 284.505l154.745-154.021c9.379-9.335 24.544-9.317 33.901.04l22.667 22.667c9.373 9.373 9.373 24.569 0 33.941L240.971 381.476c-9.373 9.372-24.569 9.372-33.942 0z\"><\/path><\/svg><\/div>\n\t\t\t\t<div class=\"elementor-toc__toggle-button elementor-toc__toggle-button--collapse\" role=\"button\" tabindex=\"0\" aria-controls=\"elementor-toc__abef9a8\" aria-expanded=\"true\" aria-label=\"Fermer la table des mati\u00e8res\"><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-up\" viewbox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M240.971 130.524l194.343 194.343c9.373 9.373 9.373 24.569 0 33.941l-22.667 22.667c-9.357 9.357-24.522 9.375-33.901.04L224 227.495 69.255 381.516c-9.379 9.335-24.544 9.317-33.901-.04l-22.667-22.667c-9.373-9.373-9.373-24.569 0-33.941L207.03 130.525c9.372-9.373 24.568-9.373 33.941-.001z\"><\/path><\/svg><\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<div id=\"elementor-toc__abef9a8\" class=\"elementor-toc__body\">\n\t\t\t<div class=\"elementor-toc__spinner-container\">\n\t\t\t\t<svg class=\"elementor-toc__spinner eicon-animation-spin e-font-icon-svg e-eicon-loading\" aria-hidden=\"true\" viewbox=\"0 0 1000 1000\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M500 975V858C696 858 858 696 858 500S696 142 500 142 142 304 142 500H25C25 237 238 25 500 25S975 237 975 500 763 975 500 975Z\"><\/path><\/svg>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-725b54a elementor-widget elementor-widget-heading\" data-id=\"725b54a\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Param\u00e8tres de discrimination<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a777f82 elementor-widget elementor-widget-text-editor\" data-id=\"a777f82\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Diff\u00e9rents algorithmes de discrimination des arythmies peuvent \u00eatre programm\u00e9s dans un d\u00e9fibrillateur Boston Scientific afin d\u2019accro\u00eetre la sp\u00e9cificit\u00e9 et de r\u00e9duire la survenue de th\u00e9rapies inappropri\u00e9es :<\/p><ul><li>RhythmID<br \/>\u00a0<\/li><li>D\u00e9but\/Stabilit\u00e9<br \/>\u00a0<\/li><li>Arr\u00eat : diagnostic bas\u00e9 sur la fr\u00e9quence cardiaque sans discrimination suppl\u00e9mentaire<\/li><\/ul><p>\u00a0<\/p><p>Dans les appareils contemporains, les discriminateurs peuvent \u00eatre programm\u00e9s dans l'une ou l'autre des zones VT ou dans les deux, mais pas dans la zone VF.<\/p><p>La pr\u00e9sence d'une sonde auriculaire permet de comparer en permanence la fr\u00e9quence ventriculaire \u00e0 la fr\u00e9quence auriculaire afin d\u2019\u00e9mettre des hypoth\u00e8ses sur l\u2019origine d\u2019un \u00e9pisode de tachycardie. Cette comparaison constitue le premier discriminateur dans les d\u00e9fibrillateurs double et triple chambre mais n'est \u00e9videmment pas possible pour un d\u00e9fibrillateur simple chambre.<\/p><p>Un certain nombre de param\u00e8tres peuvent donc \u00eatre programm\u00e9s pour optimiser la discrimination des arythmies en fonction du choix entre RhythmID et D\u00e9but\/Stabilit\u00e9 et en fonction de la pr\u00e9sence d\u2019une sonde auriculaire (ou de son bon fonctionnement) :<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6d62b8c elementor-widget elementor-widget-heading\" data-id=\"6d62b8c\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">Fr\u00e9quence ventriculaire &gt; fr\u00e9quence auriculaire<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b3d16a1 elementor-widget elementor-widget-text-editor\" data-id=\"b3d16a1\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Ce param\u00e8tre peut \u00eatre programm\u00e9 sur un d\u00e9fibrillateur double ou triple chambre en choisissant l\u2019option RhythmID ou D\u00e9but\/Stabilit\u00e9.<\/p><p>La discrimination Fr\u00e9q. V &gt; Fr\u00e9q. A (fr\u00e9quence ventriculaire sup\u00e9rieure \u00e0 fr\u00e9quence atriale) est bas\u00e9e sur une comparaison entre les fr\u00e9quences atriale et ventriculaire. Lorsque la fr\u00e9quence ventriculaire est sup\u00e9rieure \u00e0 la fr\u00e9quence atriale, le traitement est d\u00e9clench\u00e9 ind\u00e9pendamment de l\u2019analyse des autres param\u00e8tres de discrimination. Ce param\u00e8tre prime donc sur tous les autres.<\/p><p>L\u2019analyse s\u2019effectue en comparant la fr\u00e9quence moyenne des 10 derniers intervalles ventriculaires pr\u00e9c\u00e9dant la fin de la dur\u00e9e \u00e0 la fr\u00e9quence moyenne des 10 derniers intervalles atriaux pr\u00e9c\u00e9dant la fin de la dur\u00e9e.<\/p><ul style=\"font-size: 16px;\"><li>Si la fr\u00e9quence ventriculaire moyenne d\u00e9passe d\u2019au moins 10 battements\/minute la fr\u00e9quence atriale moyenne, elle est consid\u00e9r\u00e9e comme plus rapide que la fr\u00e9quence atriale (r\u00e9sultat indiqu\u00e9 par la mention Vrai dans le rapport D\u00e9tail des \u00e9pisodes) et un traitement \u00e9ventuel est d\u00e9clench\u00e9.<br>&nbsp;<\/li><li>Si la fr\u00e9quence ventriculaire moyenne n\u2019est pas sup\u00e9rieure \u00e0 la fr\u00e9quence atriale moyenne d\u2019au moins 10 battements\/minute (r\u00e9sultat indiqu\u00e9 par la mention Faux dans le rapport D\u00e9tail des \u00e9pisodes), le traitement peut \u00eatre inhib\u00e9 si les autres discriminants sont en faveur d'une TSV (l'analyse du param\u00e8tre Fr\u00e9q. V &gt; Fr\u00e9q. A se poursuit durant tout l'\u00e9pisode).<\/li><\/ul><p><br><\/p><p>Le param\u00e8tre Fr\u00e9quence V &gt; Fr\u00e9quence A n\u2019est pas \u00e9valu\u00e9 durant la red\u00e9tection qui suit le traitement par ATP.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b6516a4 elementor-widget elementor-widget-heading\" data-id=\"b6516a4\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">Corr\u00e9lation des vecteurs<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0a28f69 elementor-widget elementor-widget-text-editor\" data-id=\"0a28f69\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Ce discriminant est disponible sur les plateformes de d\u00e9fibrillateur simple, double et triple chambre en choisissant l\u2019option RhythmID.\n\nLe principe de ce param\u00e8tre de discrimination est de comparer pendant la d\u00e9tection initiale le vecteur de conduction (morphologie et synchronisation des EGM) au cours de la tachyarythmie avec un signal de r\u00e9f\u00e9rence enregistr\u00e9 en l'absence de tachycardie (RSN: rythme sinusal normal).\u00a0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ddd48eb elementor-widget elementor-widget-image\" data-id=\"ddd48eb\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination1.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"boston_va_discrimination1\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NTUzMSwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNVwvMTFcL2Jvc3Rvbl92YV9kaXNjcmltaW5hdGlvbjEucG5nIn0%3D\">\n\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"409\" height=\"456\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination1.png\" class=\"attachment-large size-large wp-image-5531\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination1.png 409w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination1-269x300.png 269w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination1-11x12.png 11w\" sizes=\"(max-width: 409px) 100vw, 409px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3c5073e elementor-widget elementor-widget-text-editor\" data-id=\"3c5073e\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>L'\u00e9lectrogramme de choc est utilis\u00e9 pour la comparaison, le champ proche \u00e9tant utilis\u00e9 pour l'alignement. La comparaison entre l'EGM de r\u00e9f\u00e9rence et l'EGM pendant la tachycardie est calcul\u00e9e \u00e0 partir des amplitudes des points de comparaison prescrits \u00e0 huit reprises (canal de choc).<\/p><p><img decoding=\"async\" src=\"https:\/\/cardiocases.com\/sites\/default\/files\/boston_1.jpg\" alt=\"\" \/>Lorsqu'un rythme rapide est d\u00e9tect\u00e9, l'appareil mesure la corr\u00e9lation entre la forme d'onde de chaque ventriculogramme d\u00e9tect\u00e9 et un mod\u00e8le de r\u00e9f\u00e9rence enregistr\u00e9 et classe chaque cycle comme \u00e9tant corr\u00e9l\u00e9 ou non corr\u00e9l\u00e9.<\/p><p>La corr\u00e9lation de chaque battement ne commence qu'apr\u00e8s le troisi\u00e8me battement rapide. Les battements suivants sont imm\u00e9diatement class\u00e9s :<\/p><ul><li>\u00a0Battements rythm\u00e9s class\u00e9s comme corr\u00e9l\u00e9s<br \/>\u00a0<\/li><li>\u00a0Les battements dans la zone VF sont automatiquement class\u00e9s comme non corr\u00e9l\u00e9s.<br \/>\u00a0<\/li><li>\u00a0Les battements trop rapides (&lt;= 260 ms ou 230 bpm) pour que le RID puisse calculer la corr\u00e9lation sont class\u00e9s comme non corr\u00e9l\u00e9s.<\/li><\/ul><p>Si la classification de la corr\u00e9lation d'un battement est connue, elle est incluse dans les 10 battements utilis\u00e9s pour classer le rythme et d\u00e9terminer la valeur RhythmMatch.<\/p><p>PREMI\u00c8RE \u00c9TAPE<\/p><ol><li>La classification commence apr\u00e8s le troisi\u00e8me temps fort.<br \/>\u00a0<\/li><li>Chaque rythme est mesur\u00e9, son pourcentage de correspondance est d\u00e9termin\u00e9.<br \/>\u00a0<\/li><li>Le rythme est class\u00e9 comme corr\u00e9l\u00e9 (correspond) ou non corr\u00e9l\u00e9 (ne correspond pas) en fonction du seuil.<\/li><\/ol><p>\u00a0<\/p><p>DEUXI\u00c8ME \u00c9TAPE<\/p><ol><li>Le rythme est class\u00e9 comme RID+ (rythme corr\u00e9l\u00e9) ou RID- (rythme non corr\u00e9l\u00e9) sur la base des 10 derniers battements.\u00a0<ul><li>Le rythme sera corr\u00e9l\u00e9 (class\u00e9 comme SVT) si 3 ou plus des 10 derniers battements atteignent ou d\u00e9passent le seuil.<\/li><\/ul><\/li><\/ol><p>\u00a0<\/p><p>La programmation du param\u00e8tre Seuil RhythmMatch ajuste le seuil utilis\u00e9 par la Corr\u00e9lation des vecteurs pour d\u00e9terminer si le cycle analys\u00e9 est corr\u00e9l\u00e9 \u00e0 son mod\u00e8le de rythme sinusal normal. Ce seuil est programmable sur les nouvelles plateformes entre 70 % et 96 %, avec une valeur nominale de 94 %. Sur les anciennes plateformes ce seuil \u00e9tait non programmable et fixe \u00e0 94%.\u00a0<\/p><p><img decoding=\"async\" src=\"https:\/\/cardiocases.com\/sites\/default\/files\/boston_2.jpg\" alt=\"\" \/>La programmation du param\u00e8tre Seuil RhythmMatch ajuste le seuil utilis\u00e9 par la Corr\u00e9lation des vecteurs pour d\u00e9terminer si le cycle analys\u00e9 est corr\u00e9l\u00e9 \u00e0 son mod\u00e8le de rythme sinusal normal. Ce seuil est programmable sur les nouvelles plateformes entre 70 % et 96 %, avec une valeur nominale de 94 %. Sur les anciennes plateformes ce seuil \u00e9tait non programmable et fixe \u00e0 94%.\u00a0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-dabf31f elementor-widget elementor-widget-image\" data-id=\"dabf31f\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination4.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"boston_va_discrimination4\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NTUzMiwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNVwvMTFcL2Jvc3Rvbl92YV9kaXNjcmltaW5hdGlvbjQucG5nIn0%3D\">\n\t\t\t\t\t\t\t<img decoding=\"async\" width=\"532\" height=\"634\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination4.png\" class=\"attachment-large size-large wp-image-5532\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination4.png 532w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination4-252x300.png 252w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination4-10x12.png 10w\" sizes=\"(max-width: 532px) 100vw, 532px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a0c58fd elementor-widget elementor-widget-image\" data-id=\"a0c58fd\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination5.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"boston_va_discrimination5\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NTUzMywidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNVwvMTFcL2Jvc3Rvbl92YV9kaXNjcmltaW5hdGlvbjUucG5nIn0%3D\">\n\t\t\t\t\t\t\t<img decoding=\"async\" width=\"527\" height=\"324\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination5.png\" class=\"attachment-large size-large wp-image-5533\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination5.png 527w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination5-300x184.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination5-18x12.png 18w\" sizes=\"(max-width: 527px) 100vw, 527px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3d743df elementor-widget elementor-widget-text-editor\" data-id=\"3d743df\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Le gabarit de r\u00e9f\u00e9rence peut \u00eatre enregistr\u00e9 automatiquement de mani\u00e8re passive ou active. Avec la m\u00e9thode passive, l'appareil recherche toutes les 2 heures la pr\u00e9sence d'un \u00e9v\u00e9nement ventriculaire spontan\u00e9 afin d'enregistrer le gabarit de r\u00e9f\u00e9rence sans modifier les r\u00e9glages programm\u00e9s. Inversement, avec la m\u00e9thode active, une recherche d'\u00e9v\u00e9nements ventriculaires spontan\u00e9s a lieu toutes les 28 heures pendant une modification temporaire des r\u00e9glages, y compris une diminution de la fr\u00e9quence de stimulation et une prolongation du d\u00e9lai AV, afin de favoriser l'\u00e9mergence d'\u00e9v\u00e9nements ventriculaires spontan\u00e9s. La m\u00e9thode active est pr\u00e9f\u00e9r\u00e9e en pr\u00e9sence d'un pourcentage \u00e9lev\u00e9 d'\u00e9v\u00e9nements ventriculaires stimul\u00e9s (chez les patients totalement d\u00e9pendants d'un stimulateur cardiaque, aucune discrimination ne doit \u00eatre programm\u00e9e). Un gabarit de r\u00e9f\u00e9rence peut \u00e9galement \u00eatre enregistr\u00e9 en temps r\u00e9el, \u00e0 l'aide du programmateur.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f1d30a1 elementor-widget elementor-widget-heading\" data-id=\"f1d30a1\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">Seuil de fr\u00e9quence de la fibrillation auriculaire<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-89acf6d elementor-widget elementor-widget-text-editor\" data-id=\"89acf6d\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Ce param\u00e8tre peut \u00eatre programm\u00e9 sur un d\u00e9fibrillateur double ou triple chambre en choisissant l\u2019option RhythmID ou D\u00e9but\/Stabilit\u00e9. L\u2019analyse du param\u00e8tre Seuil de fr\u00e9quence de Fib A est r\u00e9alis\u00e9e obligatoirement en association avec le param\u00e8tre de Stabilit\u00e9. Si la fr\u00e9quence atriale est sup\u00e9rieure au Seuil de fr\u00e9quence Fib A et que le rythme ventriculaire est class\u00e9 instable, le syst\u00e8me consid\u00e8re que le rythme ventriculaire correspond \u00e0 une FA conduite.\n\nL\u2019analyse atriale commence \u00e0 l\u2019initialisation de la d\u00e9tection de la tachyarythmie ventriculaire.\n\nChaque intervalle atrial est class\u00e9 plus rapide ou plus lent que l\u2019intervalle du Seuil de la fr\u00e9quence Fib A. Lorsque 6 des 10 derniers intervalles sont consid\u00e9r\u00e9s comme plus rapides que le Seuil de fr\u00e9quence Fib A, l\u2019appareil d\u00e9cr\u00e8te qu\u2019une FA est pr\u00e9sente. La stabilit\u00e9 ventriculaire est alors v\u00e9rifi\u00e9e et, si elle est instable, le traitement est inhib\u00e9.\n\nSi le traitement ventriculaire n\u2019est pas administr\u00e9, la fr\u00e9quence atriale continue d\u2019\u00eatre examin\u00e9e ; tant que 4 des 10 intervalles restent class\u00e9s rapides, la FA est consid\u00e9r\u00e9e comme pr\u00e9sente. Le traitement est inhib\u00e9 par Seuil de fr\u00e9quence Fib A\/Stabilit\u00e9 jusqu\u2019\u00e0 ce que l\u2019un des \u00e9v\u00e9nements suivants se produise :<\/p><ul><li>la fr\u00e9quence atriale chute en dessous du Seuil de fr\u00e9quence Fib A<\/li><li>le rythme ventriculaire devient stable\u00a0<\/li><li>si l\u2019option est programm\u00e9e sur Marche, Fr\u00e9q. V &gt; Fr\u00e9q. A est Vrai\u00a0<\/li><li>Taux soutenu La dur\u00e9e est limite<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-407d9b2 elementor-widget elementor-widget-heading\" data-id=\"407d9b2\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">Analyse de la stabilit\u00e9<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-34a878c elementor-widget elementor-widget-text-editor\" data-id=\"34a878c\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Ce discriminant est disponible sur les plateformes de d\u00e9fibrillateur simple, double et triple chambre en choisissant l\u2019option RhythmID ou l\u2019option D\u00e9but\/Stabilit\u00e9.\n\nCe param\u00e8tre peut \u00eatre utilis\u00e9 pour :<\/p><ol><li>discriminer FA (g\u00e9n\u00e9ralement instable) et TV (g\u00e9n\u00e9ralement stable)<br \/>\u00a0<\/li><li>favoriser un traitement par choc \u00e9lectrique pour un rythme instable (FV ou TV polymorphes) ou par stimulation anti-tachycardique pour un rythme stable (TV stable monomorphe)<\/li><\/ol><p>\u00a0<\/p><p>L\u2019analyse de la stabilit\u00e9 s\u2019effectue en mesurant le degr\u00e9 de variabilit\u00e9 des intervalles RR de la tachycardie. Les diff\u00e9rences entre cycles ventriculaires, ainsi qu\u2019une diff\u00e9rence moyenne, sont calcul\u00e9es tout au long de la Dur\u00e9e. Lorsque la Dur\u00e9e expire, la stabilit\u00e9 du rythme est \u00e9valu\u00e9e en comparant la diff\u00e9rence moyenne actuelle aux seuils Stabilit\u00e9 et Choc si instable programm\u00e9s. Si la diff\u00e9rence moyenne est sup\u00e9rieure aux seuils programm\u00e9s, le rythme est d\u00e9clar\u00e9 instable. Des seuils ind\u00e9pendants sont disponibles pour les fonctions Stabilit\u00e9 (inhibitrice) ou Choc si instable.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7cfb2a2 elementor-widget elementor-widget-heading\" data-id=\"7cfb2a2\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">D\u00e9marrage brutal<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e048c65 elementor-widget elementor-widget-text-editor\" data-id=\"e048c65\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Ce discriminant est disponible sur les plateformes de d\u00e9fibrillateur simple, double et triple chambre en choisissant l\u2019option D\u00e9but\/Stabilit\u00e9.\n\nLe param\u00e8tre D\u00e9but a pour objectif d\u2019inhiber le traitement ventriculaire de la zone de fr\u00e9quence tachycardique la plus basse lorsque l\u2019augmentation de la fr\u00e9quence est progressive. Son application est limit\u00e9e \u00e0 la zone de traitement la plus basse d\u2019une configuration multizone.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c10c2e8 elementor-widget elementor-widget-image\" data-id=\"c10c2e8\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination6.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"boston_va_discrimination6\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NTUzNCwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNVwvMTFcL2Jvc3Rvbl92YV9kaXNjcmltaW5hdGlvbjYucG5nIn0%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"308\" height=\"364\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination6.png\" class=\"attachment-large size-large wp-image-5534\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination6.png 308w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination6-254x300.png 254w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination6-10x12.png 10w\" sizes=\"(max-width: 308px) 100vw, 308px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ee67265 elementor-widget elementor-widget-text-editor\" data-id=\"ee67265\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Lorsqu\u2019une fen\u00eatre de d\u00e9tection devient satisfaite, le dispositif entame en deux temps les calculs de D\u00e9but soudain.<\/p><ul><li>L\u2019\u00e9tape 1 mesure les intervalles ventriculaires pr\u00e9c\u00e9dant le d\u00e9but de l\u2019\u00e9pisode et localise la paire d\u2019intervalles adjacents (point pivot) o\u00f9 la longueur du cycle a le plus diminu\u00e9. Si la diminution de la longueur du cycle est \u00e9gale ou sup\u00e9rieure \u00e0 la valeur D\u00e9but programm\u00e9e, l\u2019\u00e9tape 1 d\u00e9clare que le d\u00e9but est soudain.<br \/>\u00a0<\/li><li>L\u2019\u00e9tape 2 compare alors d\u2019autres intervalles ; si la diff\u00e9rence entre l\u2019intervalle moyen pr\u00e9c\u00e9dant le point pivot et 3 des 4 premiers intervalles suivant le point pivot est \u00e9gale ou sup\u00e9rieure au seuil D\u00e9but programm\u00e9, l\u2019\u00e9tape 2 d\u00e9clare que le d\u00e9but est soudain.<\/li><\/ul><p>\u00a0<\/p><p>Si les deux \u00e9tapes d\u00e9clarent que le rythme est soudain, le traitement peut \u00eatre d\u00e9livr\u00e9. Si l\u2019une des deux \u00e9tapes indique un d\u00e9but progressif, le traitement ventriculaire initial est inhib\u00e9 dans la zone la plus basse. Le traitement n\u2019est pas inhib\u00e9 par D\u00e9but si la fr\u00e9quence s\u2019acc\u00e9l\u00e8re vers une zone ventriculaire plus \u00e9lev\u00e9e.<\/p><p>Ce param\u00e8tre peut \u00eatre programm\u00e9 en tant que pourcentage de la dur\u00e9e du cycle ou en dur\u00e9e d\u2019intervalle (en ms). La valeur D\u00e9but choisie repr\u00e9sente la diff\u00e9rence minimum qui doit exister entre les intervalles sup\u00e9rieurs et inf\u00e9rieurs au seuil de fr\u00e9quence programm\u00e9 le plus bas.<\/p><p><strong>Caract\u00e9ristiques suppl\u00e9mentaires :<\/strong><\/p><ul><li>Taux V &gt; Taux A<ul><li><em>Si V est plus rapide que A,\u00a0<\/em>indique le rythme ventriculaire et initie le traitement<\/li><\/ul><\/li><\/ul><ul><li>Seuil du taux de fibrillation auriculaire<ul><li>Peut \u00eatre programm\u00e9 <em>(en m\u00eame temps que la stabilit\u00e9)<\/em>\u00a0pour inhiber la th\u00e9rapie ventriculaire si le rythme auriculaire est rapide<\/li><\/ul><\/li><\/ul><ul><li>Taux soutenu Dur\u00e9e<ul><li><em>\u00c0 la fin du d\u00e9lai SRD<\/em>, une th\u00e9rapie est propos\u00e9e<\/li><\/ul><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5480890 elementor-widget elementor-widget-heading\" data-id=\"5480890\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">Dur\u00e9e du taux soutenu (SRD)<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b7c9171 elementor-widget elementor-widget-text-editor\" data-id=\"b7c9171\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Ce discriminant est disponible sur les plateformes de d\u00e9fibrillateur simple, double et triple chambre en choisissant l\u2019option RhythmID ou l\u2019option D\u00e9but\/Stabilit\u00e9.\n\nCe param\u00e8tre permet d\u2019administrer le traitement ventriculaire programm\u00e9 apr\u00e8s une dur\u00e9e programmable (il s'agit d'une minuterie) m\u00eame si les autres discriminants sont en faveur d\u2019une origine supra-ventriculaire de l\u2019arythmie.\n\nLa DFS peut \u00eatre programm\u00e9e s\u00e9par\u00e9ment pour les zones TV et TV-1.\n\nUne valeur DFS post-choc ind\u00e9pendante peut \u00eatre programm\u00e9e.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4984026 elementor-widget elementor-widget-heading\" data-id=\"4984026\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Combinaison de diff\u00e9rents discriminateurs<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7834534 elementor-widget elementor-widget-text-editor\" data-id=\"7834534\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Il est possible de combiner ces diff\u00e9rents discriminants pour optimiser la discrimination de l'origine des arythmies. \u00a0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5d4453a elementor-widget elementor-widget-image\" data-id=\"5d4453a\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination7.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"boston_va_discrimination7\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NTUzNSwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNVwvMTFcL2Jvc3Rvbl92YV9kaXNjcmltaW5hdGlvbjcucG5nIn0%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"526\" height=\"365\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination7.png\" class=\"attachment-large size-large wp-image-5535\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination7.png 526w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination7-300x208.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination7-18x12.png 18w\" sizes=\"(max-width: 526px) 100vw, 526px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9ab78d4 elementor-widget elementor-widget-heading\" data-id=\"9ab78d4\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">RhythmID<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-821a7df elementor-widget elementor-widget-text-editor\" data-id=\"821a7df\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Cette option permet de combiner diff\u00e9rents param\u00e8tres en fonction de la pr\u00e9sence d'une sonde auriculaire et de son bon fonctionnement: seuil de fr\u00e9quence Fib A, Fr\u00e9q. V &gt; Fr\u00e9q. A, stabilit\u00e9 et corr\u00e9lation des Vecteurs. Cette association n'est disponible que pour la d\u00e9tection initiale.\n\nSeuil de fr\u00e9quence Fib A et Fr\u00e9q. V &gt; Fr\u00e9q. A sont tous deux activ\u00e9s lorsque Discrimination tachyarythmie atriale est programm\u00e9e sur Marche. Si Fr\u00e9q. V &gt; Fr\u00e9q. A est programm\u00e9e sur Marche et est Vrai, elle a la priorit\u00e9 sur toutes les autres discriminants.<\/p><p>Lorsque Discrimination tachyarythmie atriale est programm\u00e9e sur Arr\u00eat, la corr\u00e9lation des vecteurs est utilis\u00e9e pour la d\u00e9tection initiale et la stabilit\u00e9 pour la d\u00e9tection post-choc.<\/p><p>Quand tous ces param\u00e8tres sont activ\u00e9s, le dispositif proc\u00e8de suivant diff\u00e9rentes \u00e9tapes:<\/p><ul><li>si la fr\u00e9quence ventriculaire est consid\u00e9r\u00e9e sup\u00e9rieure \u00e0 la fr\u00e9quence atriale : diagnostic de TV\u00a0<\/li><li>si la fr\u00e9quence ventriculaire n'est pas consid\u00e9r\u00e9e comme sup\u00e9rieure \u00e0 la fr\u00e9quence atriale, l\u2019analyse de la corr\u00e9lation des vecteurs au cours de la d\u00e9tection initiale d\u00e9termine si la corr\u00e9lation entre le rythme du patient en tachycardie et le mod\u00e8le de r\u00e9f\u00e9rence est sup\u00e9rieure ou \u00e9gale au Seuil RhythmMatch programm\u00e9. Si c'est le cas le rythme est class\u00e9 comme \u00e9tant une TSV et le traitement est inhib\u00e9.\u00a0<\/li><li>si la corr\u00e9lation entre le rythme du patient en tachycardie et le mod\u00e8le de r\u00e9f\u00e9rence n'est pas sup\u00e9rieure ou \u00e9gale au Seuil RhythmMatch programm\u00e9 (en faveur d'une TV ou d'une TSV avec aberration de conduction), la stabilit\u00e9 et le Seuil de fr\u00e9quence Fib A sont analys\u00e9s. Si le rythme ventriculaire est instable et la fr\u00e9quence atriale rapide (en faveur d'une FA conduite avec aberration de conduction), le rythme est d\u00e9clar\u00e9 comme \u00e9tant une TSV et le traitement est inhib\u00e9.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8ae89c1 elementor-widget elementor-widget-image\" data-id=\"8ae89c1\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination8.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"boston_va_discrimination8\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NTUzNiwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNVwvMTFcL2Jvc3Rvbl92YV9kaXNjcmltaW5hdGlvbjgucG5nIn0%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"533\" height=\"377\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination8.png\" class=\"attachment-large size-large wp-image-5536\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination8.png 533w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination8-300x212.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination8-18x12.png 18w\" sizes=\"(max-width: 533px) 100vw, 533px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d4f7b07 elementor-widget elementor-widget-heading\" data-id=\"d4f7b07\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">D\u00e9but\/Stabilit\u00e9<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9dd6122 elementor-widget elementor-widget-text-editor\" data-id=\"9dd6122\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Cette option permet de combiner diff\u00e9rents param\u00e8tres en fonction de la pr\u00e9sence d'une sonde auriculaire et de son bon fonctionnement: seuil de fr\u00e9quence Fib A, Fr\u00e9q. V &gt; Fr\u00e9q. A, d\u00e9but et stabilit\u00e9. Cette association n'est disponible que pour la d\u00e9tection initiale.<\/p><p>Seuil de fr\u00e9quence Fib A et Fr\u00e9q. V &gt; Fr\u00e9q. A sont tous deux activ\u00e9s lorsque Discrimination tachyarythmie atriale est programm\u00e9e sur Marche. Si Fr\u00e9q. V &gt; Fr\u00e9q. A est programm\u00e9e sur Marche et est Vrai, elle a la priorit\u00e9 sur tous les autres discriminants.<\/p><p>Si les param\u00e8tres Seuil de fr\u00e9quence Fib A, Stabilit\u00e9 et D\u00e9but sont tous programm\u00e9s sur Marche, le traitement ventriculaire est d\u00e9clench\u00e9 si le rythme conna\u00eet un d\u00e9but soudain \u00e0 condition que la fr\u00e9quence ventriculaire soit stable ou que la fr\u00e9quence atriale soit inf\u00e9rieure au Seuil de fr\u00e9quence Fib A.<\/p><p>Pour un d\u00e9fibrillateur simple chambre quand d\u00e9but et stabilit\u00e9 sont programm\u00e9s, deux options sont disponibles :<\/p><ul><li>D\u00e9but et Stabilit\u00e9 : pour qu'un traitement soit d\u00e9livr\u00e9, les 2 crit\u00e8res (d\u00e9but brutal et rythme stable) sont n\u00e9cessaires.<\/li><li>D\u00e9but ou Stabilit\u00e9 : pour qu'un traitement soit d\u00e9livr\u00e9, un seul crit\u00e8re positif (d\u00e9but brutal et\/ou rythme stable) est suffisant.\u00a0<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a8553a7 elementor-widget elementor-widget-image\" data-id=\"a8553a7\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination9.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"boston_va_discrimination9\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NTUzNywidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNVwvMTFcL2Jvc3Rvbl92YV9kaXNjcmltaW5hdGlvbjkucG5nIn0%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"582\" height=\"468\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination9.png\" class=\"attachment-large size-large wp-image-5537\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination9.png 582w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination9-300x241.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination9-15x12.png 15w\" sizes=\"(max-width: 582px) 100vw, 582px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f8f9f50 elementor-widget elementor-widget-image\" data-id=\"f8f9f50\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination10.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"boston_va_discrimination10\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NTUzOCwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNVwvMTFcL2Jvc3Rvbl92YV9kaXNjcmltaW5hdGlvbjEwLnBuZyJ9\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"542\" height=\"411\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination10.png\" class=\"attachment-large size-large wp-image-5538\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination10.png 542w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination10-300x227.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/boston_va_discrimination10-16x12.png 16w\" sizes=\"(max-width: 542px) 100vw, 542px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Boston Scientific &#8211; Discrimination Content Discrimination parameters Various arrhythmia discrimination algorithms can be programmed with a view to increase the specificity and lower the rate of inappropriate therapies: Rhythm ID\u00a0 Onset\/Stability\u00a0 OFF: diagnosis based on the heart rate without additional discrimination. \u00a0 In the contemporary devices, the discriminators can be programmed in either or both [&hellip;]<\/p>","protected":false},"author":1,"featured_media":0,"parent":51,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-701","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Boston Scientific ICD SVT\/VT Discrimination Guide | Cardiocases<\/title>\n<meta name=\"description\" content=\"How Boston Scientific ICD discriminates SVT from VT \u2014 SmartShock, RhythmID, detection algorithms &amp; real ECG tracings. 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