Wide-Complex Tachycardia in a Patient With Cardiomyopathy.

Tex Heart Inst J

Division of Cardiac Electrophysiology, Texas Heart Institute, Houston, Texas.

Published: June 2021

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8262832PMC
http://dx.doi.org/10.14503/THIJ-20-7255DOI Listing

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Article Synopsis
  • Differentiating between ventricular tachycardia (VT) and supraventricular wide tachycardia (SWCT) using 12-lead ECG is challenging and has traditionally depended on manual interpretation, which can be limited by the user's expertise.
  • Recent research has introduced automated algorithms that may offer improved accuracy over manual methods, but there has been little direct comparison between these two approaches.
  • A study by LoCoco et al. (2024) evaluated the effectiveness of traditional manual ECG differentiation methods against five automated algorithms, analyzing 213 ECGs to assess their diagnostic performance.
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Background: Wide QRS complex tachycardia (WCT) differentiation into ventricular tachycardia (VT) and supraventricular wide complex tachycardia (SWCT) remains challenging despite numerous 12-lead electrocardiogram (ECG) criteria and algorithms. Automated solutions leveraging computerized ECG interpretation (CEI) measurements and engineered features offer practical ways to improve diagnostic accuracy. We propose automated algorithms based on (i) WCT QRS polarity direction (WCT Polarity Code [WCT-PC]) and (ii) QRS polarity shifts between WCT and baseline ECGs (QRS Polarity Shift [QRS-PS]).

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Atrial flutter with 1:1 atrioventricular conduction is a rare cause of wide complex tachycardia, which presents a diagnostic challenge. This report describes a series of eight cases of 1:1 atrial flutter compiled during 2018-2022. The cases in this report include patients without class 1 anti-arrhythmic use or pre-excitation.

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