Wide complex tachycardia discrimination tool improves physicians' diagnostic accuracy.
J Electrocardiol
; 74: 32-39, 2022.
Article
in En
| MEDLINE
| ID: mdl-35933848
ABSTRACT
BACKGROUND:
Timely and accurate discrimination of wide complex tachycardias (WCTs) into ventricular tachycardia (VT) or supraventricular WCT (SWCT) is critically important. Previously we developed and validated an automated VT Prediction Model that provides a VT probability estimate using the paired WCT and baseline 12-lead ECGs. Whether this model improves physicians' diagnostic accuracy has not been evaluated.OBJECTIVE:
We sought to determine whether the VT Prediction Model improves physicians' WCT differentiation accuracy.METHODS:
Over four consecutive days, nine physicians independently interpreted fifty WCT ECGs (25 VTs and 25 SWCTs confirmed by electrophysiological study) as either VT or SWCT. Day 1 used the WCT ECG only, Day 2 used the WCT and baseline ECG, Day 3 used the WCT ECG and the VT Prediction Model's estimation of VT probability, and Day 4 used the WCT ECG, baseline ECG, and the VT Prediction Model's estimation of VT probability.RESULTS:
Inclusion of the VT Prediction Model data increased diagnostic accuracy versus the WCT ECG alone (Day 3 84.2% vs. Day 1 68.7%, p 0.009) and WCT and baseline ECGs together (Day 3 84.2% vs. Day 2 76.4%, p 0.003). There was no further improvement of accuracy with addition of the baseline ECG comparison to the VT Prediction Model (Day 3 84.2% vs. Day 4 84.0%, p 0.928). Overall sensitivity (Day 3 78.2% vs. Day 1 67.6%, p 0.005) and specificity (Day 3 90.2% vs. Day 1 69.8%, p 0.016) for VT were superior after the addition of the VT Prediction Model.CONCLUSION:
The VT Prediction Model improves physician ECG diagnostic accuracy for discriminating WCTs.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Physicians
/
Electrocardiography
Type of study:
Diagnostic_studies
/
Prognostic_studies
Limits:
Humans
Language:
En
Journal:
J Electrocardiol
Year:
2022
Document type:
Article