Valles et al developed a simple algorithm using ECG changes to diagnose epicardial ventricular tachycardia in a patient with nonischemic cardiomyopathy. The authors are from the University of Pennsylvania and Universitat Autonoma de Barcelona.
Patient selection: nonischemic cardiomyopathy with ventricular tachycardia
Parameters:
(1) q waves in inferior leads (II, III and aVF)
(2) duration of the pseudo-delta wave in milliseconds
(3) MDI = maximum deflection index, which is the (a) interval from the earliest ventricular activation (or stimulation artifact) to the peak of the largest amplitude deflection using the lead with the shortest time (b) divided the QRS duration (QRSd)
(4) q wave in lead I
q waves in inferior leads
pseudo-delta wave
MDI
q wave in lead I
Diagnosis
Y
NA
NA
NA
not EPI
N
>= 75 ms
NA
NA
EPI
N
< 75 ms
>= 0.59
NA
EPI
N
< 75 ms
< 0.59
Y
EPI
N
< 75 ms
< 0.59
N
not EPI
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