Identification of ventricular tachycardias by means of fast wavelet analysis

Discrimination of ventricular tachycardias at slow rate from sinus tachycardia still remains a challenge for implantable antitachycardia devices. It was the purpose of this study to assess the feasibility of endocardial signal processing using fast wavelet analysis (FWA) as a novel approach for discrimination of ventricular tachycardia (VT) and normal sinus rhythm (NSR). During an electrophysiological study, bipolar endocardial signals were obtained from the right ventricle in patients with known monomorphic VT. FWA was applied to single endocardial activations. The distribution of energy in the time-scale domain clearly discriminated between endocardial signals obtained during NSR and VT in each particular patient when using an individually adjusted wavelet. In patients with multiple VTs, identification of each VT with different morphology was also achievable.