Electrocardiography Screening for Hypertrophic Cardiomyopathy.

Background Hypertrophic cardiomyopathy (HCM) is the leading cause of sudden cardiac death in athletes. However, preparticipation electrocardiogram (ECG) screening has been criticized for failing to meet cost-effectiveness thresholds, in part because of high false-positive rates. We sought to evaluat...

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Publicado en:Pacing & Clinical Electrophysiology Vol. 39; no. 9; pp. 944 - 951
Autores principales: CAMPBELL, MATTHEW J., ZHOU, XUEFU, HAN, CHIA, ABRISHAMI, HEDAYAT, WEBSTER, GREGORY, MIYAKE, CHRISTINA Y., KNILANS, TIMOTHY K., CZOSEK, RICHARD J.
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Sep2016
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Electrocardiography Screening for Hypertrophic Cardiomyopathy.
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          CAMPBELL, MATTHEW J.
          ZHOU, XUEFU
          HAN, CHIA
          ABRISHAMI, HEDAYAT
          WEBSTER, GREGORY
          MIYAKE, CHRISTINA Y.
          KNILANS, TIMOTHY K.
          CZOSEK, RICHARD J.
        affil: Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati Ohio
      sug:
        subj:
          Cardiomyopathy, Hypertrophic Diagnosis
          Electrocardiography
          Algorithms
          Diagnosis, Computer Assisted
          Human
          Sensitivity and Specificity
          ROC Curve
          Health Screening
          Retrospective Design
          Adolescence
          Prospective Studies
          Genotype
          QRS Complex
          Comparative Studies
          ST Segment
          False Positive Results
          Funding Source
          Adolescent: 13-18 years
      ab: Background Hypertrophic cardiomyopathy (HCM) is the leading cause of sudden cardiac death in athletes. However, preparticipation electrocardiogram (ECG) screening has been criticized for failing to meet cost-effectiveness thresholds, in part because of high false-positive rates. We sought to evaluate whether a highly automated software algorithm could be used for a high throughput, population-based screening program and address several of the limitations seen with population-based screening Methods A proprietary computed algorithm was created based on both voltage- as well as Seattle-based ECG criteria. Different cut points for Q-wave depth, Q-wave length, the degree of ST depression, the degree of T-wave inversion, and left ventricular voltage were analyzed for optimum sensitivity and specificity. After developing receiver operating characteristic curves for each criterion, different cut points were trialed together on our data set to obtain settings to optimize sensitivity and specificity. Results The automated algorithm was capable of identifying patients with HCM based on ECG with 88.6% sensitivity and 98% specificity, compared to a sensitivity of 90.2% and specificity of 96% when the ECGs were read by physicians according to the Seattle Criteria. Adding voltage criteria improved the sensitivity of the algorithm with a mild decrease in specificity. Optimum sensitivity with this automated software was 98%; optimum specificity was 96%. Conclusion Computer-automated ECG screening for HCM is feasible. Evaluation of automated ECG algorithms in larger and more diverse populations is warranted.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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