Diagnostic value of ventricular tachycardia integral method with increased positive criteria in wide QRS complex tachycardia / 中国医师进修杂志

ABSTRACT

Objective:To investigate the diagnostic value of ventricular tachycardia (VT) integral and VT integral with increased positive criteria in wide QRS wave tachycardia (WCT).Methods:The electrocardiogram characteristics of 146 patients with WCT from January 2013 to July 2018 in Liaocheng People′s Hospital of Shandong Province were retrospectively analyzed. The diagnostic value of VT integral, Brugada four-step, Vereckei four-step and increased positive criteria "V 1 to V 6 lead RS valley time ≥ 100 ms" and "initial excite velocity (Vi)/terminal excite velocity (Vt) ≤ 1" were studied. Results:The positive criteria from first to fifth and seventh of the VT integral had lower sensitivity but higher specificity, which was consistent with the principle. The accuracy, sensitivity and negative predictive value of VT integral were significantly lower than Brugada four-step and Vereckei four-step (51.4% vs. 83.6% and 80.8%, 34.6% vs. 92.5% and 93.5%, 35.2% vs. 74.2% and 72.0%), the specificity was significantly higher than Brugada four-step and Vereckei four-step (97.4% vs. 59.0% and 46.2%),and there were statistical differences ( P<0.05). The sensitivity of the VT integral with increased positive criteria "V 1 to V 6 lead RS valley time ≥ 100 ms" and "Vi/Vt ≤ 1" was significantly higher than that of VT integral (61.7% and 65.4% vs. 34.6%), and there was statistical difference ( P<0.05); additionally, the specificity did not decrease. Conclusions:The VT integral has higher specificity but lower sensitivity for WCT. When the VT integral fails to diagnosis, V 1 to V 6 lead RS valley time ≥ 100 ms and Vi/Vt≤ 1 can increase the positive standard, and improve the accuracy of VT further.