TY - JOUR
T1 - The WCT Formula II
T2 - An effective means to automatically differentiate wide complex tachycardias
AU - Kashou, Anthony H.
AU - DeSimone, Christopher V.
AU - Deshmukh, Abhishek J.
AU - McGill, Trevon D.
AU - Hodge, David O.
AU - Carter, Rickey
AU - Cooper, Daniel H.
AU - Cuculich, Phillip S.
AU - Noheria, Amit
AU - Asirvatham, Samuel J.
AU - Noseworthy, Peter A.
AU - May, Adam M.
N1 - Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Background: Differentiation of wide complex tachycardias (WCTs) into ventricular tachycardia (VT) or supraventricular wide complex tachycardia (SWCT) using conventional manually-operated electrocardiogram (ECG) interpretation methods is difficult. Recent research has shown that accurate WCT differentiation may be accomplished by automated approaches (e.g., WCT Formula) implemented by computerized ECG interpretation software. Objective: We sought to develop a new automated means to differentiate WCTs. Methods: First, a derivation cohort of paired WCT and baseline ECGs was examined to secure independent VT predictors to be incorporated into a logistic regression model (i.e., WCT Formula II). Second, the WCT Formula II was trialed against a separate validation cohort of paired WCT and baseline ECGs. Results: The derivation cohort comprised 317 paired WCT (157 VT, 160 SWCT) and baseline ECGs. The WCT Formula II was composed of baseline QRS duration (p = 0.02), WCT QRS duration (p < 0.001), frontal percent time-voltage area change (p < 0.001), and horizontal percent time-voltage area change (p < 0.001). The area under the curve (AUC) for VT and SWCT differentiation was 0.96 (95% CI 0.94–0.98) for the derivation cohort. The validation cohort consisted of 284 paired WCT (116 VT, 168 SWCT) and baseline ECGs. WCT Formula II implementation on the validation cohort yielded effective WCT differentiation (AUC 0.96; 95% CI 0.94–0.98). Conclusion: The WCT Formula II is an example of how contemporary ECG interpretation software could be used to differentiate WCTs successfully.
AB - Background: Differentiation of wide complex tachycardias (WCTs) into ventricular tachycardia (VT) or supraventricular wide complex tachycardia (SWCT) using conventional manually-operated electrocardiogram (ECG) interpretation methods is difficult. Recent research has shown that accurate WCT differentiation may be accomplished by automated approaches (e.g., WCT Formula) implemented by computerized ECG interpretation software. Objective: We sought to develop a new automated means to differentiate WCTs. Methods: First, a derivation cohort of paired WCT and baseline ECGs was examined to secure independent VT predictors to be incorporated into a logistic regression model (i.e., WCT Formula II). Second, the WCT Formula II was trialed against a separate validation cohort of paired WCT and baseline ECGs. Results: The derivation cohort comprised 317 paired WCT (157 VT, 160 SWCT) and baseline ECGs. The WCT Formula II was composed of baseline QRS duration (p = 0.02), WCT QRS duration (p < 0.001), frontal percent time-voltage area change (p < 0.001), and horizontal percent time-voltage area change (p < 0.001). The area under the curve (AUC) for VT and SWCT differentiation was 0.96 (95% CI 0.94–0.98) for the derivation cohort. The validation cohort consisted of 284 paired WCT (116 VT, 168 SWCT) and baseline ECGs. WCT Formula II implementation on the validation cohort yielded effective WCT differentiation (AUC 0.96; 95% CI 0.94–0.98). Conclusion: The WCT Formula II is an example of how contemporary ECG interpretation software could be used to differentiate WCTs successfully.
UR - http://www.scopus.com/inward/record.url?scp=85086859123&partnerID=8YFLogxK
U2 - 10.1016/j.jelectrocard.2020.05.004
DO - 10.1016/j.jelectrocard.2020.05.004
M3 - Article
C2 - 32599290
AN - SCOPUS:85086859123
SN - 0022-0736
VL - 61
SP - 121
EP - 129
JO - Journal of Electrocardiology
JF - Journal of Electrocardiology
ER -