Herz-Kreislauf-Erkrankungen und Diagnose

The Value of Brugada Algorithm in the Differential Diagnosis of Broad QRS Complex Tachycardia: A Meta-Analysis

Abstract

Qiaoying Chai, Gang Liu, HaiJun Zhang and Mingqi Zheng

Background: The diagnosis precision of Brugada algorithm in discriminating between supraventricular tachycardia and ventricular tachycardia remains controversial. We aim to evaluate the diagnostic value of Brugada algorithm in broad complex tachycardia arrhythmia.
Methods: Eligible studies were identified through searching PubMed, Embase, Web of Science databases, Wan Fang data resource, China National Knowledge Infrastructure prior to 5st January 2018. Studies were assessed for quality using the Quality Assessment for Studies of Diagnostic Accuracy, 2nd version (QUADAS-2). Pooled sensitivity and pooled specificity with 95% confidence interval (CI) were calculated using random-effects models. Summary receiver operator characteristic (SROC) curves and the area under curve (AUC) were performed.
Results: A total of 13 studies including 1918 electrocardiogram (ECG) were enrolled in this meta-analysis. The pooled sensitivity and specificity were 0.92(95% CI: 0.88–0.95), and 0.71(95% CI: 0.57-0.82), respectively. The positive likelihood ratio was 3 (95% CI, 2.0–5.0) and the negative likelihood ratio was 0.11 (95% CI, 0.06–0.19). The summary Diagnostic Odds Ratio (DOR) was 29 (95% CI: 12–72). The AUC was 0.95. Meta-regression analysis showed that sample size, study type and region were not the major sources of heterogeneity, the publication date may account for heterogeneity.
Conclusion: Brugada algorithm has excellent pooled sensitivity and moderate pooled specificity for discriminating SVT from VT. It deserves to be widely used as clinical diagnostic methods.