A High Precision Algorithm to Classify Left and Right Outflow Tract
Ventricular Tachycardia
Abstract
Several algorithms based on 12-lead ECG measurements have been proposed
to identify right ventricular outflow tract (RVOT) and left ventricular
outflow tract (LVOT) locations from which ventricular tachycardia (VT)
and frequent premature ventricular complex (PVC) originated. However, a
clinical-grade artificial intelligence algorithm is not available yet,
which can automatically analyze characteristics of 12-lead ECGs and
predict RVOT to LVOT origins of VT and PVC. We randomly sampled
training, validation, and testing datasets from 420 patients who
underwent successful catheter ablation (CA) to treat VT or PVCs,
containing (340, 80%), (38, 9%), and (42, 10%) patients,
respectively. We iteratively trained an AI algorithm that was supplied
with 1,600,800 features extracted from 12-lead ECGs of the patients in
the training cohort. The area under the curve (AUC) of the receiver
operating characteristic (ROC) curve was calculated from the internal
validation dataset to choose an optimal discretization cutoff threshold.
After running on the testing dataset, the proposed approach attained the
following performance metrics and 95% CIs (confidence intervals),
accuracy (ACC) of 97.62 (87.44 -99.99), weighted F1-score of 98.46
(90-100), AUC of 98.99 (96.89-100), sensitivity (SE) of 96.97
(82.54-99.89), and specificity (SP) of 100 (62.97-100). The proposed
multi-stage diagnostic scheme attained clinical-grade precision of
prediction for LVOT and RVOT locations of VT origin with fewer
applicability restrictions than prior studies.