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Specificity of the wide QRS complex tachycardia algorithms in recipients of cardiac resynchronization therapy.

Abstract：

BACKGROUND:We assessed the specificity of wide QRS complex tachycardia (WCT) differentiating algorithms in patients with preexistent left bundle branch block (LBBB) and heart failure. METHODS:Three hundred fourteen patients with resynchronization devices were retrospectively screened. electrocardiograms with supraventricular LBBB rhythm were used as a surrogate for supraventricular tachycardia QRS morphology. The Pava lead II criterion, ventricular activation velocity ratio (Vi/Vt) ratio in V(2), Vereckei aVR, Brugada, Griffith, and Bayesian algorithms were investigated. RESULTS:The WCT algorithms had a lower specificity (33%-69%) in patients with LBBB than in general WCT populations. The Pava lead II criterion and Brugada algorithm had higher specificity than other algorithms (P < .05). Several of the single criteria (absence of an RS complex in V(1) through V(6), initial R wave in aVR, Vi/Vt < 1 in V(2)) had specificities of 92% to 99%. CONCLUSIONS:In patients with heart failure and LBBB, an electrocardiographic diagnosis of ventricular tachycardia should be based on selected, specific criteria rather than on WCT algorithms.

journal_name

J Electrocardiol

journal_title

Journal of electrocardiology

authors

Jastrzebski M,Kukla P,Czarnecka D,Kawecka-Jaszcz K

doi

10.1016/j.jelectrocard.2011.08.012

subject

Has Abstract

pub_date

2012-05-01 00:00:00

pages

319-26

issue

3

eissn

0022-0736

issn

1532-8430

pii

S0022-0736(11)00328-1

journal_volume

45

pub_type

临床试验,杂志文章

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