1. The ventricular tachycardia score: a novel approach to electrocardiographic diagnosis of ventricular tachycardia.
- Author
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Jastrzebski, Marek, Kenichi Sasaki, Kukla, Piotr, Fijorek, Kamil, Stec, Sebastian, Czarnecka, Danuta, and Sasaki, Kenichi
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ACTION potentials ,ALGORITHMS ,COMPARATIVE studies ,ELECTROCARDIOGRAPHY ,HEART ventricles ,HEART beat ,RESEARCH methodology ,MEDICAL cooperation ,RESEARCH ,RESEARCH evaluation ,SIGNAL processing ,EVALUATION research ,VENTRICULAR tachycardia ,PREDICTIVE tests ,RESEARCH bias ,DIAGNOSIS - Abstract
Aims: Electrocardiographic diagnosis of wide QRS complex tachycardia (WCT) continues to be challenging as none one of the available methods is specific for ventricular tachycardia (VT) diagnosis. We aimed to construct a method for WCT differentiation based on a scoring system, in which ECGs are graded according to the number of VT-specific features. This novel method was validated and compared with Brugada algorithm and other methods.Methods and Results: A total of 786 WCTs (512 VTs) from 587 consecutive patients with a proven diagnosis were analysed by two blinded observers. The VT score method was based on seven ECG features: initial R wave in V1, initial r > 40 ms in V1/V2, notched S in V1, initial R in aVR, lead II R wave peak time ≥50 ms, no RS in V1-V6, and atrioventricular dissociation. Atrioventricular dissociation was assigned two points, and each of the other features was assigned one point. The overall accuracy of VT score ≥1 for VT diagnosis (83%) was higher than that of the aVR (72%, P = 0.001) and Brugada (81%) algorithms. Ventricular tachycardia score ≥3 was present in 66% of VTs and was more specific (99.6%) than any other algorithm/criterion for VT diagnosis. Ventricular tachycardia score ≥4 was present in 33% of VTs and was 100% specific for VT.Conclusion: The new ECG-based method provides a certain diagnosis of VT in the majority of patients with VT, identifies unequivocal ECGs, and has superior overall diagnostic accuracy to other ECG methods. [ABSTRACT FROM AUTHOR]- Published
- 2016
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