{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T06:58:27Z","timestamp":1785394707624,"version":"3.55.0"},"reference-count":41,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T00:00:00Z","timestamp":1690156800000},"content-version":"unspecified","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Several ECG-based algorithms have been proposed to enhance the effectiveness of distinguishing Wide QRS complex tachycardia (WCT), but a comprehensive comparison of their accuracy is still lacking. This meta-analysis aimed to assess the diagnostic precision of various non-artificial intelligence ECG-based algorithms for WCT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Systematic review with meta-analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data sources<\/jats:title><jats:p>Electronic databases (PubMed, MEDLINE, the Cochrane Library, and Web of Science) are searched up to May 2022.<\/jats:p><\/jats:sec><jats:sec><jats:title>Eligibility criteria for selecting studies<\/jats:title><jats:p>All studies reporting the diagnostic accuracy of different ECG-based algorithms for WCT are included. The risk of bias in included studies is assessed using the Cochrane Collaboration\u2019s risk of bias tools.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data extraction and synthesis<\/jats:title><jats:p>Two independent reviewers extracted data and assessed risk of bias. Data were pooled using random-effects model and expressed as mean differences with 95% CIs. Heterogeneity was calculated by the I<jats:sup>2<\/jats:sup>method. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was applied to assess the internal validity of the diagnostic studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 467 studies were identified, and 14 studies comprising 3966 patients were included, involving four assessable ECG-based algorithms: the Brugada algorithm, Vereckei-pre algorithm, Vereckei-aVR algorithm and R wave peak time of lead II (RWPT-II) algorithm. The overall sensitivity was 88.89% (95% CI: 85.03 to 91.86), with a specificity of 70.55% (95% CI: 62.10 to 77.79) and a diagnostic OR (DOR) of 19.17 (95% CI: 11.45 to 32.10). Heterogeneity of the DOR was 89.1%. The summary sensitivity of each algorithm was Brugada 90.25%, Vereckei-pre 94.80%, Vereckei-aVR 90.35% and RWPT-II 78.15%; the summary specificity was Brugada 64.02%, Vereckei-pre 75.40%, Vereckei-aVR 60.88% and RWPT-II 88.30% and the summary DOR was Brugada 16.48, Vereckei-pre 60.70, Vereckei-aVR 14.57 and RWPT-II 27.00.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>ECG-based algorithms exhibit high sensitivity and moderate specificity in diagnosing WCT. A combination of Brugada or Vereckei-aVR algorithm with RWPT-II could be considered to diagnose WCT.<\/jats:p><\/jats:sec><jats:sec><jats:title>PROSPERO registration number<\/jats:title><jats:p>CRD42022344996.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2022-069273","type":"journal-article","created":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T16:45:28Z","timestamp":1690217128000},"page":"e069273","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Diagnostic accuracy of different ECG-based algorithms in wide QRS complex tachycardia: a systematic review and meta-analysis"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7283-0981","authenticated-orcid":false,"given":"Xingxing","family":"Sun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanling","family":"Teng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengnan","family":"Mu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7283-0981","authenticated-orcid":false,"given":"Yilian","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0006-2485","authenticated-orcid":false,"given":"Hongwu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,7,24]]},"reference":[{"key":"2023072409450847000_13.7.e069273.1","first-page":"1340","article-title":"Initial evaluation and management of wide-complex tachycardia: A simplified and practical approach","volume":"37","author":"Littmann","year":"2019","journal-title":"Am J Emerg Med"},{"key":"2023072409450847000_13.7.e069273.2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(78)90176-6"},{"key":"2023072409450847000_13.7.e069273.3","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1016\/j.ajem.2017.07.056","article-title":"The differential diagnosis of wide QRS complex tachycardia","volume":"35","author":"Brady","year":"2017","journal-title":"The American Journal of Emergency Medicine"},{"key":"2023072409450847000_13.7.e069273.4","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euq430"},{"key":"2023072409450847000_13.7.e069273.5","doi-asserted-by":"publisher","DOI":"10.1136\/heart.86.5.579"},{"key":"2023072409450847000_13.7.e069273.6","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1016\/S0733-8627(20)30594-0","article-title":"Wide complex tachycardia","volume":"13","author":"Delbridge","year":"1995","journal-title":"Emerg Med Clin North Am"},{"key":"2023072409450847000_13.7.e069273.7","doi-asserted-by":"crossref","first-page":"260","DOI":"10.4037\/ajcc2001.10.4.260","article-title":"Electrophysiology study: a comprehensive review","volume":"10","author":"Attin","year":"2001","journal-title":"Am J Crit Care"},{"key":"2023072409450847000_13.7.e069273.8","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-109-11-905"},{"key":"2023072409450847000_13.7.e069273.9","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.83.5.1649"},{"key":"2023072409450847000_13.7.e069273.10","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.66.2.166"},{"key":"2023072409450847000_13.7.e069273.11","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehl473"},{"key":"2023072409450847000_13.7.e069273.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2007.09.020"},{"key":"2023072409450847000_13.7.e069273.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2010.03.001"},{"key":"2023072409450847000_13.7.e069273.14","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euv118"},{"key":"2023072409450847000_13.7.e069273.15","doi-asserted-by":"publisher","DOI":"10.1111\/pace.13658"},{"key":"2023072409450847000_13.7.e069273.16","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/j.cmpb.2018.04.009","article-title":"Wide complex tachycardia discrimination using dynamic time warping of ECG beats","volume":"164","author":"Mazandarani","year":"2018","journal-title":"Comput Methods Programs Biomed"},{"key":"2023072409450847000_13.7.e069273.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelectrocard.2019.02.008"},{"key":"2023072409450847000_13.7.e069273.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelectrocard.2020.05.004"},{"key":"2023072409450847000_13.7.e069273.19","doi-asserted-by":"publisher","DOI":"10.1111\/jce.14321"},{"key":"2023072409450847000_13.7.e069273.20","doi-asserted-by":"crossref","unstructured":"Kashou AH , LoCoco S , McGill TD , et al . 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