The novel ventricular tachycardia score (≥1 point) demonstrated higher overall diagnostic accuracy for VT (83%) compared to the aVR algorithm (72%, P=0.001) and Brugada algorithm (81%).
Observational (n=587)
Blinded observers
Does the VT score method improve the diagnostic accuracy of ventricular tachycardia in patients with wide QRS complex tachycardia compared to the Brugada and aVR algorithms?
A novel 7-feature ECG-based VT score offers superior diagnostic accuracy and near-perfect specificity for identifying ventricular tachycardia among wide QRS complex tachycardias.
Absolute Event Rate: 83% vs 72%
p-value: p=0.001
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.
Jastrzębski et al. (Tue,) conducted a observational in Wide QRS complex tachycardia (n=587). Ventricular tachycardia (VT) score vs. aVR and Brugada algorithms was evaluated on Overall accuracy for VT diagnosis (p=0.001). The novel ventricular tachycardia score (≥1 point) demonstrated higher overall diagnostic accuracy for VT (83%) compared to the aVR algorithm (72%, P=0.001) and Brugada algorithm (81%).