Simple electrocardiographic criteria for rapid identification of wide QRS complex tachycardia: The new limb lead algorithm

Chen, Qiong; Gianni, Carola; Trivedi, Chintan; Rocca, Domenico G. Della; Bassiouny, Mohammed; Canpolat, Uğur; Tapia, Alfredo Chauca; Burkhardt, J. David; Sánchez, Javier; Hranitzky, Patrick; Gallinghouse, G. Joseph; Al‐Ahmad, Amin; Horton, Rodney; Biase, Luigi Di; Mohanty, Sanghamitra

doi:10.1016/j.hrthm.2019.09.021

Cited by 37 publications

(23 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Atrial Tachycardia with aberration 9.4% (17) Unclassified SVT with aberration 9.4% (17) detail. Among the 4 leads studied (I, aVF, V1 and V6), certain waveforms (Q, QS, Qr or qR waveforms) in aVF was found to be the most useful with a 72% predictive accuracy for VT. Our findings were in congruence with this study and we noted a 78.2% accuracy in diagnosing VT based on the presence of a similar Q-wave pattern in all 3 inferior leads.…”

Section: Discussionmentioning

confidence: 99%

“…Recently Chen et al, published a new algorithm named limb lead algorithm (LLA) to differentiate VT from SVT in WCTs. 17 As per this algorithm, VT is diagnosed in the presence of at least 1 of the following: (1) monophasic R wave in lead aVR; (2) predominantly negative QRS in leads I, II, and III and (3) opposing QRS complex in the limb leads (OQL): concordant monophasic QRS in all 3 inferior leads and concordant monophasic QRS in 2 or 3 of the remaining limb leads with a polarity opposite to that of the inferior leads. LLA algorithm had a sensitivity of 87.2% and a specificity of 90.8% as reported in the study.…”

Section: Discussionmentioning

confidence: 99%

“…Unlike previous studies which compared diagnostic accuracy of algorithms to the final diagnosis obtained using invasive electrophysiology study as gold standard, all patients in our cohort did not undergo electrophysiologic study. 17 This may be considered both as a strength and a limitation of the study. In real world, it is difficult to justify the need for an EP study on all cases of WCT.…”

Section: Strenghts and Limitationsmentioning

confidence: 99%

See 2 more Smart Citations

Utility of Inferior Lead Q-waveforms in diagnosing Ventricular Tachycardia

Subramany

Kattoor

Kovelamudi

et al. 2020

Clin Med Insights Cardiol

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Strenghts and Limitationsmentioning

confidence: 99%

See 1 more Smart Citation

Utility of Inferior Lead Q-waveforms in diagnosing Ventricular Tachycardia

Subramany

Kattoor

Kovelamudi

et al. 2020

Clin Med Insights Cardiol

View full text Add to dashboard Cite

show abstract

“…При восстановлении СР у гемодинамически стабильных пациентов с НЖТ рекомендуется регистрация ЭКГ с целью перманентного контроля эффективности и безопасности лечения [88][89][90][91][92][93][94][95][96].…”

Section: неотложная терапия наджелудочковых тахикардийunclassified

2020 Clinical practice guidelines for Supraventricular tachycardia in adults

Бокерия¹,

Голухова²,

Попов³

et al. 2021

Russ J Cardiol

View full text Add to dashboard Cite

show abstract

“…This year has seen several publications on the ECG diagnosis of supraventricular tachycardia (SVT) [1][2][3][4] and interest in new consumer-led discovery of supraventricular arrhythmias. 5 EP mapping technology has provided better mapping of SVT.…”

Section: Supraventricular Tachycardiasmentioning

confidence: 99%