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THE VALUE OF “OLD AND NEW” ELECTROCARDIOGRAPHIC CRITERIA IN DIFFERENTIATION OF WIDE QRS-COMPLEX TACHYCARDIAS
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Abstract
Aim: To make a comparison between the sensitivity (SN), specificity (SP), and diagnostic accuracy (ACC) of five electrocardiographic approaches for wide QRS-complex tachycardia (WCT) differentiation including the Brugada, Bayesian, Griffith, and aVR algorithms, and the lead II R-wave-peak-time (RWPT) criterion (PAVA). Method and results: 86 WCTs from 86 individuals with verified diagnosis were studied retrospectively. For each approach, the SN, SP, ACC, and likelihood ratios (LRs) were calculated. There were 38 VTs and 48 SVTs among the 86 ECG tracings. The ACC of all five approaches was found to be comparable, with the exception of the DII RWPT (PAVA), which had a lower ACC than the Brugada algorithm (69.8% vs. 78.2%, P = 0.031). The SN of PAVA (60.5%) was lower than that of the Brugada (88.0%), Griffith (94.2%), and Bayesian (88.6%) algorithm (P < 0.001). The SP of the Griffith algorithm (39.8%) was lower than that of PAVA (77.1%), Brugada (58.9%), and Bayesian (51.7%) algorithms (P < 0.05). Positive LRs for a VT diagnosis were 2.64, 2.13, 1.89, 1.60, and 1.57, respectively, using the DII RWPT criteria and the Brugada, Bayesian, aVR, and Griffith algorithms. Conclusion: We discovered that the ACC of all five algorithms/criteria was modest, and that the newer approaches were not superior to the traditional Brugada algorithm.
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Keywords
Ventricular tachycardia, Supraventricular tachycardia, Wide QRS-complex tachycardia, Brugada algorithm, aVR algorithm
References
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