ELECTROPHYSIOLOGISTS demonstrated that computational algorithms were more accurate in differentiating wide complex tachycardias (WCTs) into ventricular tachycardia (VT) and supraventricular wide tachycardia, compared to manual ECG interpretation methods.
In this study, two electrophysiologists compared the diagnostic efficacy of five novel automated WCT differentiation methods (WCT Formula, WCT Formula II, VT Prediction Model, Solo Model, and Paired Model) to traditional ECG interpretation approaches (Brugada, Vereckei aVR, and VT score).
The data consisted of 212 WCTs from 104 patients, comprising 111 cases of VT and 101 cases of supraventricular wide tachycardia. Among the manual methods, the VT score showed an accuracy of 84.4%, with high sensitivity (93.8%) but lower specificity (74.2%). The Brugada and Vereckei aVR approaches demonstrated lower accuracy and specificity, with Brugada achieving an accuracy of 75.2% and specificity of 57.4%, and Vereckei aVR achieving an accuracy of 65.3% and specificity of 36.4%.
In comparison, the WCT Formula and WCT Formula II demonstrated superior accuracy and specificity. The WCT Formula achieved 85.8% accuracy, 84.7% sensitivity, and 87.1% specificity, whilst WCT Formula II achieved 89.8% accuracy, 89.6% sensitivity, and 85.1% specificity. The Paired Model excelled in accuracy (89.6%) and specificity (97.0%), significantly outperforming the Brugada and Vereckei aVR methods. The Solo Model and VT Prediction Model demonstrated better performance than the Vereckei aVR, but were comparable to the Brugada and VT score methods.
The study concluded that automated WCT differentiation algorithms exhibit favourable diagnostic performance compared to traditional manual ECG interpretation approaches. In particular, the WCT Formula II and Paired Model algorithms demonstrated superior accuracy and specificity. These findings suggest that automated algorithms could serve as reliable alternatives or adjuncts to manual ECG interpretation, potentially improving diagnostic accuracy in clinical practice and aiding clinicians in making more informed decisions for treating patients with wide complex tachycardias.
Katrina Thornber, EMJ
Reference
LoCoco S et al. Direct comparison of methods to differentiate wide complex tachycardias: novel automated algorithms versus manual ECG interpretation approaches. Circulation: Arrhythmia and Electrophysiology. 2024;DOI:10.1161/CIRCEP.123.012663.
