Study on value of initial and teiminal ventricular activation velocity of the 12-lead electrocardiogram in differential diagnosis of wide QRS-complex tachycardia
ZHANG Ling-zhi
YU Ling-qi
WANG Yun-he
ZHANG Zu-wen
LIU Qiang
JIANG Ru-hong
SUN Ya-xun
YU Lu
ZHANG Pei
CHEN Shi-quan
SHENG Xia
JIANG Chen-yang
Abstract：Objective The purpose of this study was to explore the value of the initial(Vi)and teiminal(Vt)ventricular activation velocity and ratio of them(Vi/Vt)of every electrocardiographic(ECG)leads in the differential diagnosis of Wide QRS-complex Tachycardia(WCT).Methods 100 WCTs[including 70 cases of ventricular tachycardia(VT)and 30 cases of supraventricular tachycardia(SVT)]from 100 patients with proven diagnoses at the Run Run Shaw Hospital from November 2011 to June 2020 were analyzed.Vi and Vt of every ECG leads of the WCTs were measured,Vi/Vt were calculated,and ROC curves were drawn to compare the efficacy of these indicators in differential diagnosis of WCT.Results In terms of Vi,SVTs were faster than VTs in I,avR and V1-V6 leads(P＜0.05).Vt of SVTs were slower than that of VTs in limb and V4-V6 leads(P＜0.01).The Vi/Vt value of SVTs in most ECG leads,except lead V1,were higher than that of VTs(P＜0.05).According to ROC curve analysis,lead avR and V5 had the largest and similar area under the curve(AUC)of 0.85(0.76-0.91)and 0.86(0.77-0.92),respectively,and the optimal critical value was 1.75 for both.Combined with QRS duration,the AUC were the highest when the QRS duration of the avR and V5 leads were between 120-159 ms,and the optimal critical value is significantly increased when the QRS duration of the avR and V5 leads were less than 120 ms.Conclusion The Vi/Vt ratio of the avR and V5 leads are move valuable in the differential diagnosis of WCT than other ECG leads,but the optimal cutoff value of them may not be 1,and for different QRS and different ECG leads,setting a suitable Vi/Vt critecal value may help to improve the performance of WCT differential diagnosis.
Keywords：wide QRS-complex tachycardiaventricular tachycardiasupraventricular tachycardiaelectrocardiogram
Publication Date：2024-11-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 921-927 )