title: The ventricular tachycardia score: a novel approach to electrocardiographic diagnosis of ventricular tachycardia.
abstract: Electrocardiographic diagnosis of wide QRS complex tachycardia (WCT) continues to be challenging as none one of the available methods is specific for ventricular tachycardia (VT) diagnosis. We aimed to construct a method for WCT differentiation based on a scoring system, in which ECGs are graded according to the number of VT-specific features. This novel method was validated and compared with Brugada algorithm and other methods.
  
  
  
  A total of 786 WCTs (512 VTs) from 587 consecutive patients with a proven diagnosis were analysed by two blinded observers. The VT score method was based on seven ECG features: initial R wave in V1, initial r > 40 ms in V1/V2, notched S in V1, initial R in aVR, lead II R wave peak time ≥50 ms, no RS in V1-V6, and atrioventricular dissociation. Atrioventricular dissociation was assigned two points, and each of the other features was assigned one point. The overall accuracy of VT score ≥1 for VT diagnosis (83%) was higher than that of the aVR (72%, P = 0.001) and Brugada (81%) algorithms. Ventricular tachycardia score ≥3 was present in 66% of VTs and was more specific (99.6%) than any other algorithm/criterion for VT diagnosis. Ventricular tachycardia score ≥4 was present in 33% of VTs and was 100% specific for VT.
  
  
  
  The new ECG-based method provides a certain diagnosis of VT in the majority of patients with VT, identifies unequivocal ECGs, and has superior overall diagnostic accuracy to other ECG methods.
authors.affiliation: First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University, College of Medicine, ul. Kopernika 17, Cracow 31-501, Poland mcjastrz@cyf-kr.edu.pl.
authors.forename: Marek
authors.initials: M
authors.lastname: Jastrzebski
authors.affiliation: Department of Cardiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sasaki
authors.affiliation: Department of Internal Medicine and Cardiology, H. Klimontowicz Specialistic Hospital, Gorlice, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Kukla
authors.affiliation: Department of Statistics, Cracow University of Economics, Cracow, Poland.
authors.forename: Kamil
authors.initials: K
authors.lastname: Fijorek
authors.affiliation: Department of Medicine, University of Rzeszow, Rzeszow, Poland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Stec
authors.affiliation: First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University, College of Medicine, ul. Kopernika 17, Cracow 31-501, Poland.
authors.forename: Danuta
authors.initials: D
authors.lastname: Czarnecka
mesh_terms: D000200:Action Potentials; D000328:Adult; D000368:Aged; D000465:Algorithms; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006339:Heart Rate; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011044:Poland; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012815:Signal Processing, Computer-Assisted; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000503:physiopathology
keywords: Brugada algorithm; Electrocardiography; Ventricular tachycardia; Wide QRS complex tachycardia