Man vs machine: Performance of manual vs automated electrocardiogram analysis for predicting the chamber of origin of idiopathic ventricular arrhythmia.

Background: Radiofrequency catheter ablation of idiopathic ventricular arrhythmias (VAs) is performed to eliminate symptoms and to prevent or reverse arrhythmia‐induced cardiomyopathy. Preprocedural prediction of the chamber of VA origin is critical for patient counseling, procedure planning, and gu...

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Publicado en:Journal of Cardiovascular Electrophysiology Vol. 31; no. 2; pp. 410 - 417
Autores principales: Asatryan, Babken, Ebrahimi, Ramin, Strebel, Ivo, Dam, Peter M., Kühne, Michael, Knecht, Sven, Spies, Florian, Abächerli, Roger, Badertscher, Patrick, Kozhuharov, Nikola, Zeljkovic, Ivan, Schaer, Beat, Osswald, Stefan, Sticherling, Christian, Reichlin, Tobias
Formato: diagnostic images research tables/charts tracings Journal Article
Publicado: Wiley-Blackwell Feb2020
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Man vs machine: Performance of manual vs automated electrocardiogram analysis for predicting the chamber of origin of idiopathic ventricular arrhythmia.
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          Asatryan, Babken
          Ebrahimi, Ramin
          Strebel, Ivo
          Dam, Peter M.
          Kühne, Michael
          Knecht, Sven
          Spies, Florian
          Abächerli, Roger
          Badertscher, Patrick
          Kozhuharov, Nikola
          Zeljkovic, Ivan
          Schaer, Beat
          Osswald, Stefan
          Sticherling, Christian
          Reichlin, Tobias
        affil: Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern Switzerland
      sug:
        subj:
          Electrocardiography Methods
          Arrhythmia, Ventricular Diagnosis
          Cardiologists
          Algorithms
          Sensitivity and Specificity
          Human
          Record Review
          Arrhythmia, Ventricular Surgery
          Catheter Ablation Methods
          Vectorcardiography Methods
          Adult
          Middle Age
          Female
          Male
          Imaging, Three-Dimensional Methods
          Heart Ventricle, Left Pathology
          Heart Ventricle, Right Pathology
          Premature Ventricular Contractions Diagnosis
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Background: Radiofrequency catheter ablation of idiopathic ventricular arrhythmias (VAs) is performed to eliminate symptoms and to prevent or reverse arrhythmia‐induced cardiomyopathy. Preprocedural prediction of the chamber of VA origin is critical for patient counseling, procedure planning, and guidance of invasive mapping. Objective: We aimed to assess the performance of manual expert versus automated 12‐lead electrocardiogram (ECG) analysis in the prediction of VA origin. Methods: Patients with ablation of idiopathic VA and sustained success were included. The VA origin was defined as the site where ablation caused arrhythmia suppression. Standard baseline 12‐lead ECGs with documentation of the VA were analyzed manually in a blinded fashion by three electrophysiologists and three electrophysiology (EP) fellows. In addition, the same standard 12‐lead ECG was analyzed by an automated computer algorithm using a vectorcardiographic approach. Results: Thirty‐eight patients (median age, 47 [interquartile range, 37–58]; 68% female) were enrolled. The VA originated from the right ventricle in 24 (63%) and the left ventricle in 14 (37%) patients. The electrophysiologists and EP fellows identified the VA chamber of origin with a similar accuracy of 73% and 72% (P =.72). The automated algorithm showed a higher accuracy of 89% (P =.03 compared with electrophysiologists and EP fellows). This resulted in a sensitivity of 95% and specificity of 86%. Conclusion: While the manual ECG analysis of the standard 12‐lead ECG by both electrophysiologists and EP fellows correctly identified the chamber of VA origin in around 75% of cases, an automated vectorcardiographic computer algorithm achieved an accuracy of 89% with clinically acceptable diagnostic parameters.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        tracings
        Journal Article
      ougenre: Article
    language: English
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