| Evaluation of the specificity of morphological electrocardiographic criteria for the differential diagnosis of wide QRS complex tachycardia in patients with intraventricular conduction defects. | |
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MedLine Citation:
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PMID: 9396451 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Although several ECG criteria have been described for the differential diagnosis of tachycardias with a wide QRS complex, their applicability in patients with preexisting intraventricular conduction defects (IVCDs) has been questioned. The specificity of previously described criteria in this context is unknown. METHODS AND RESULTS: We analyzed prospectively the specificity of the QRS morphological criteria previously described in ECGs during sinus rhythm of 232 patients with IVCD. Only 5 of 12 analyzed criteria had a specificity > or = 0.90 among our patients: (1) a triphasic configuration (Rsr' or Rr') QRS complex in V1 in the presence of a right bundle-branch block morphology (BBBM); (2) a QS, QR, or R QRS pattern in V6 in the presence of a right BBBM; (3) any Q in V6 in the presence of a left BBBM; (4) a concordant pattern in all precordial leads; and (5) the absence of an RS complex in all precordial leads (particularly useful for left BBBM). The following criteria--QRS duration > 140 ms; a left axis with right BBBM, right superior axis with right BBBM, monophasic or biphasic R wave in V1 with right BBBM, and a relation R/S < 1 with right BBBM; an R > 30 ms in lead V1 or V2 with left BBBM, > 60 ms from QRS onset to S nadir with left BBBM, a notched downstroke S wave with left BBBM, and an R-to-S interval > 100 ms in one precordial lead--had a specificity of 0.43, 0.54, 0.87, 0.80, 0.85, 0.78, 0.66, 0.69, and 0.63 (0.84 in right BBBM), respectively. CONCLUSIONS: Most of the previously described morphological criteria favoring ventricular tachycardia are present in a substantial percentage of patients with IVCD during sinus rhythm. These findings suggest a limited applicability of these criteria in this subset of patients. |
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Authors:
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T Alberca; J Almendral; P Sanz; A Almazan; J L Cantalapiedra; J L Delcán |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Circulation Volume: 96 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1997 Nov |
Date Detail:
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Created Date: 1998-01-09 Completed Date: 1998-01-09 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 3527-33 Citation Subset: AIM; IM |
Affiliation:
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Departamento de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Arrhythmias, Cardiac / diagnosis*, physiopathology Bundle-Branch Block / diagnosis, physiopathology Diagnosis, Differential Electrocardiography / methods* Evaluation Studies as Topic Female Heart Rate / physiology Humans Male Middle Aged Prospective Studies Reference Values Sensitivity and Specificity Tachycardia, Ventricular / diagnosis*, physiopathology Ventricular Dysfunction / physiopathology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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