Wide complex tachycardia discrimination tool improves physicians' diagnostic accuracy.

Autor: Kashou AH; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States of America. Electronic address: kashou.anthony@mayo.edu., Noseworthy PA; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States of America., Jentzer JC; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States of America; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States of America., Rafie N; Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States of America., Roy AR; Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States of America., Abraham HM; Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States of America., Sang PD; Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States of America., Kronzer EK; Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States of America., Inglis SS; Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States of America., Rezkalla JA; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States of America., Julakanti RR; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States of America., Saric P; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States of America., Asirvatham SJ; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States of America., Deshmukh AJ; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States of America., DeSimone CV; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States of America., May AM; Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States of America.
Jazyk: angličtina
Zdroj: Journal of electrocardiology [J Electrocardiol] 2022 Sep-Oct; Vol. 74, pp. 32-39. Date of Electronic Publication: 2022 Aug 02.
DOI: 10.1016/j.jelectrocard.2022.07.070
Abstrakt: 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.
Competing Interests: Declaration of Competing Interest Anthony Kashou, Peter Noseworthy, Christopher DeSimone, Abhishek Deshmukh, and Adam May are potential beneficiaries of intellectual property discussed in the article. The remaining authors have no disclosures to report.
(Copyright © 2022. Published by Elsevier Inc.)
Databáze: MEDLINE
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