| Home | E-Submission | Sitemap | Contact Us |  
top_img
J Korean Soc Emerg Med > Volume 16(4); 2005 > Article
Journal of The Korean Society of Emergency Medicine 2005;16(4): 441-447.
Diagnostic Value of the Brugada Algorithm in Differential Diagnosis of Wide QRS Tachycardia by Electrocardiogram
Wook Jin Choi, Won Kim, Hui Dong Kang, Yoo Dong Sohn, Jae Ho Lee, Bum Jin Oh, Kyoung Soo Lim
Department of Emergency Medicine, College of Medicine, Ulsan University, Seoul, Korea. wkim@amc.seoul.kr
ABSTRACT
PURPOSE:
In dealing with wide-complex tachycardia (WCT), it is important to distinguish between ventricular tachycardia (VT), supraventricular tachycardia with aberrancy (SVTAC), and preexcited tachycardia by using an accessory pathway. The aim of this study was to investigate and compare the Brugada and the Bayesian algorithms and to analyze the parameters.
METHODS:
Between January 1999 and December 2003, the Brugada and the Bayesian approaches were retrospectively analyzed in 103 WCTs confirmed by electrophysiologic studies.
RESULTS:
Seven-eight (75) VTs and 25 SVTs were found. The sensitivity and the specificity for VT achieved by using the Brugada approach were 91.0 and 68.0%, respectively, whereas those achieved by using the Bayesian approach were 84.6 and 60.0%. In the Brugada approach, the most important step was the fourth step (odds ratio: 4.33; 95% CI: 1.75-12.14). In the Bayesian approach, triphasic rsR' or rR' morphology (odds ratio: 3.93; 95% CI: 1.46-10.56), r > or = 0.04 s or notched S downstroke or delayed S nadir > 0.06 s in the V1 or the V2 lead (odds ratio: 5.75; 95% CI: 1.26?26.28), and intrinsicoid deflection > or = 0.08 s in the V6 lead (odds ratio: 6.88; 95% CI: 1.33-27.79) were more important parameters. Seven (7) VTs of 103 tachycardias were mis-classified when the Brugada approach was used. Applying additional criteria (QRS width > 0.16 s and intrinsicoid deflection > or = 0.08 s in V6 lead), three of those VTs were diagnosed correctly.
CONCLUSIONS:
The Brugada algorithm achieved a lower sensitivity and specificity than those reported by Brugada et al. If both the V1 and the V6 leads do not fulfill the criteria for VT, additional parameters should be evaluated.
Key words: Ventricular tachycardia, Supraventricular tachycardia with aberrancy, Wide-complex tachycardia, Brugada criteria
TOOLS
PDF Links  PDF Links
Full text via DOI  Full text via DOI
Download Citation  Download Citation
Share:      
METRICS
1,444
View
19
Download
Related articles
Deagnostic Value of Myoglobin in Early Diagnosis of Acute Myocardial Infarction  1999 June;10(2)
Penetrating Atherosclerotic Ulcer: Another Differential Diagnosis of Widened Mediastinum  2011 October;22(5)
Editorial Office
The Korean Society of Emergency Medicine
TEL: +82-62-226-1780   FAX: +82-62-224-3501   E-mail: 5151649@naver.com
About |  Browse Articles |  Current Issue |  For Authors and Reviewers
Copyright © The Korean Society of Emergency Medicine.                 Developed in M2PI