A comparison of four new time-domain techniques for discriminating monomorphic ventricular tachycardia from sinus rhythm using ventricular waveform morphology

The authors have designed four new computationally efficient time-domain algorithms for distinguishing ventricular electrograms during monomorphic ventricular tachycardia (VT) from those during sinus rhythm using direct analysis of the ventricular electrogram morphology. All four techniques are independent of amplitude fluctuations and three of the four are independent of baseline changes. These new techniques were compared to correlation waveform analysis, a previously proposed method for distinction of VT from sinus rhythm. Evaluation of these four new algorithms was performed on data from 19 consecutive patients with 31 distinct monomorphic ventricular tachycardia morphologies. Three of the algorithms performed as well as or better than correlation waveform analysis but with one-tenth to one-half the computational demands.