Computer interpretation of the 12-lead electrocardiogram, the Frank-lead vectorcardiogram and the reconstructed vectorcardiogram

The purpose of this study was to assess the diagnostic accuracy of the computer interpretations of the electrocardiogram (ECG), the vectorcardiogram (VCG) and their combination (COMB) on a large data base of 2810 patients with adequate clinical documentation. On a series of 2414 patients without ventricular conduction defect, the evaluation also included the VCG reconstructed from the 12-lead ECG (VCGr), and its combination with the ECG (COMBr). The authors found that COMB and COMBr reached the highest level of overall accuracy, the highest specificity, and the highest sensitivity in diagnosing left ventricular hypertrophy, mixed myocardial infarction (MI) and MI associated with hypertrophy. The VCGr was equivalent to the original Frank VCG except in inferior MI. On another series of 396 patients with ventricular conduction defect, the sensitivity of COMB was superior for ventricular hypertrophy and MI, at the expense of a lower specificity. It is concluded that the combination of the diagnostic results obtained by two computer programs is worthwhile, and that the reconstructed VCG might be considered for clinical use.<
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