Utility of Inferior Lead Q-waveforms in diagnosing Ventricular Tachycardia.
Background: Electrocardiogram (ECG) differentiation of wide complex tachycardia (WCT) into ventricular tachycardia (VT) and supraventricular tachycardia with aberration (SVT-A) is often challenging. Objective: To determine if the presence of Q-waveforms (QS, Qr, QRs) in the inferior leads (II, III,...
| Publicado en: | Clinical Medicine Insights: Cardiology Vol. 14; pp. 1 - 6 |
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| Autores principales: | , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
8/30/2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=145432278&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 145432278 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 11795468 B3KL jtl: Clinical Medicine Insights: Cardiology issn: 11795468 maglogo: Y pubinfo: dt: 8/30/2020 vid: 14 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 145432278 145432278 145432278 10.1177/1179546820953416 145432278 ppf: 1 ppct: 5 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Utility of Inferior Lead Q-waveforms in diagnosing Ventricular Tachycardia. aug: au: Subramany, Swathi Kattoor, Ajoe John Kovelamudi, Swathi Devabhaktuni, Subodh Mehta, Jawahar L Vallurupalli, Srikanth Paydak, Hakan Pothineni, Naga Venkata K affil: Division of Internal medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA sug: subj: Tachycardia, Ventricular Diagnosis Electrocardiography Brugada Syndrome Algorithms Cardiac Patients Sensitivity and Specificity ROC Curve Retrospective Design Descriptive Statistics Human ab: Background: Electrocardiogram (ECG) differentiation of wide complex tachycardia (WCT) into ventricular tachycardia (VT) and supraventricular tachycardia with aberration (SVT-A) is often challenging. Objective: To determine if the presence of Q-waveforms (QS, Qr, QRs) in the inferior leads (II, III, aVF) can differentiate VT from SVT-A in a WCT compared to Brugada algorithm. We studied 2 inferior lead criteria namely QWC-A where all the inferior leads had a similar Q wave pattern and QWC-B where only lead aVF had a Q-waveform. Methods: A total of 181 consecutive cases of WCT were identified, digitally separated into precordial leads and inferior leads and independently reviewed by 2 electrophysiologists. An electrocardiographic diagnosis of VT or SVT-A was assigned based on Brugada and inferior lead algorithms. Results were compared to the final clinical diagnosis. Results: VT was the final clinical diagnosis in 24.9% of ECG cohort (45/181); 75.1% (136/181) were SVT-A. QWC-A and QWC-B had a high specificity (93.3% and 82.8%) and accuracy (78.2% and 71.0%), but low sensitivity (33.3% and 35.6%) in differentiating VT from SVT-A. The Brugada algorithm yielded a sensitivity of 82.2% and specificity of 68.4%. Area under the curve in ROC analysis was highest with Brugada algorithm (0.75, 95% CI 0.69-0.81) followed by QWC-A (0.63, 95% CI 0.56-0.70) and QWC-B (0.59, 95% CI 0.52-0.67). Conclusion: QWC-A and QWC-B criteria had poor sensitivity but high specificity in diagnosing VT in patients presenting with WCT. Further research combining this simple criterion with other newer diagnostic algorithms can potentially improve the accuracy of the overall diagnostic algorithm. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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