BACKGROUND:The aim of this study was to determine the frequency and nature of errors made by computer electrocardiogram (ECG) analysis of atrial fibrillation (AF), and the clinical consequences. HYPOTHESIS:Computer software for interpreting ECGs has advanced. METHODS:A total of 10279 ECGs were collected, automatically interpreted by the built-in ECG software, and then reread by 2 cardiologists. AF-related ECGs were classified into 3 groups: overinterpreted AF (rhythms other than AF interpreted as AF), misinterpreted AF (AF interpreted as rhythms other than AF), and true AF (AF interpreted as AF by both computer ECG interpretation and cardiologists). RESULTS:There were 1057 AF-related ECGs from 409 patients. Among these, 840 ECGs (79.5%) were true AF. Overinterpretation occurred in 98 (9.3%) cases. Sinus rhythm and sinus tachycardia with premature atrial contraction and/or baseline artifact and sinus arrhythmia were commonly overinterpreted as AF. Heart rate ≤60 bpm and baseline artifact significantly increased the likelihood of overinterpreted AF. Misdiagnosis occurred in 119 (11.3%) cases, in which AF was usually misdiagnosed as sinus or supraventricular tachycardia. The presence of tachycardia and low-amplitude atrial activity significantly increased the likelihood of misdiagnosis of AF. Among the erroneous computer ECG interpretations, 17 cases (7.8%) were not corrected by the ordering physicians and/or repeat computer-ECG interpretation; inappropriate follow-up studies or treatments of the patients were undertaken with no serious sequelae. CONCLUSIONS:Erroneous computer ECG interpretation of AF was not rare. Attention should be concentrated on educating physicians about ECG appearance and confounding factors of AF, along with ongoing quality control of built-in software for automatic ECG interpretation.

译文

背景:本研究的目的是确定通过计算机心电图(ECG)对房颤(AF)进行分析的错误的频率和性质,以及其临床后果。
假设:用于解释心电图的计算机软件已得到改进。
方法:总共收集了10279个心电图,并通过内置的心电图软件​​自动解释,然后由2位心脏病专家重新读取。与AF相关的ECG分为3组:过度解释的AF(除AF以外的其他节奏被解释为AF),误解的AF(AF视为除AF之外的节奏)和真实AF(由计算机ECG解释和心脏病专家解释为AF) 。
结果:409例患者中有1057例与AF相关的心电图。其中,有840个ECG(占79.5%)是真正的AF。 98(9.3%)例发生了过度解释。窦性心律和窦性心动过速伴房性早搏和/或基线假象和窦性心律不齐通常被误​​认为是房颤。心率≤60 bpm和基线伪影显着增加了过度解释房颤的可能性。 119例(11.3%)发生误诊,通常将AF误诊为窦性或室上性心动过速。心动过速和低幅度房性活动的存在显着增加了房颤误诊的可能性。在错误的计算机心电图解释中,有17例(7.8%)没有被订购医生纠正和/或重复进行计算机心电图解释;对患者进行了不适当的随访研究或治疗,没有严重的后遗症。
结论:错误的计算机心电图对房颤的解释并不罕见。应将注意力集中在教育医生有关心电图的出现和房颤的混杂因素,以及用于自动心电图解释的内置软件的持续质量控制方面。

+1
+2
100研值 100研值 ¥99课程
检索文献一次
下载文献一次

去下载>

成功解锁2个技能,为你点赞

《SCI写作十大必备语法》
解决你的SCI语法难题!

技能熟练度+1

视频课《玩转文献检索》
让你成为检索达人!

恭喜完成新手挑战

手机微信扫一扫,添加好友领取

免费领《Endnote文献管理工具+教程》

微信扫码, 免费领取

手机登录

获取验证码
登录