Abstract:
BACKGROUND:Differentiation of wide complex tachycardias (WCTs) into ventricular tachycardia (VT) or supraventricular wide complex tachycardia (SWCT) using conventional manually-operated electrocardiogram (ECG) interpretation methods is difficult. Recent research has shown that accurate WCT differentiation may be accomplished by automated approaches (e.g., WCT Formula) implemented by computerized ECG interpretation software. OBJECTIVE:We sought to develop a new automated means to differentiate WCTs. METHODS:First, a derivation cohort of paired WCT and baseline ECGs was examined to secure independent VT predictors to be incorporated into a logistic regression model (i.e., WCT Formula II). Second, the WCT Formula II was trialed against a separate validation cohort of paired WCT and baseline ECGs. RESULTS:The derivation cohort comprised 317 paired WCT (157 VT, 160 SWCT) and baseline ECGs. The WCT Formula II was composed of baseline QRS duration (p = 0.02), WCT QRS duration (p < 0.001), frontal percent time-voltage area change (p < 0.001), and horizontal percent time-voltage area change (p < 0.001). The area under the curve (AUC) for VT and SWCT differentiation was 0.96 (95% CI 0.94-0.98) for the derivation cohort. The validation cohort consisted of 284 paired WCT (116 VT, 168 SWCT) and baseline ECGs. WCT Formula II implementation on the validation cohort yielded effective WCT differentiation (AUC 0.96; 95% CI 0.94-0.98). CONCLUSION:The WCT Formula II is an example of how contemporary ECG interpretation software could be used to differentiate WCTs successfully.
journal_name
J Electrocardioljournal_title
Journal of electrocardiologyauthors
Kashou AH,DeSimone CV,Deshmukh AJ,McGill TD,Hodge DO,Carter R,Cooper DH,Cuculich PS,Noheria A,Asirvatham SJ,Noseworthy PA,May AMdoi
10.1016/j.jelectrocard.2020.05.004subject
Has Abstractpub_date
2020-01-01 00:00:00pages
121-129eissn
0022-0736issn
1532-8430pii
S0022-0736(20)30164-3journal_volume
61pub_type
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