Value of computer-assisted analysis of the electrocardiogram, the vectorcardiogram, and the combined electro-vectorcardiogram in the diagnosis of `complex´ abnormalities

The authors assessed the usefulness of computer-assisted interpretation of the electrocardiogram (ECG), the vectorcardiogram (VCG), and the combined ECG-VCG in 323 complex cases with associated abnormalities. In 136 cases with major ventricular conduction defects, the ability to diagnose a left ventricular hypertrophy (LVH) was less than 50% but the performance for myocardial infarction (MI) was higher than 70%. There was no significant difference between ECG and VCG. The slight advantage of combining the two methods was not significant. In 41 cases with associated LVH and MI, the full diagnosis was quite difficult because of the high rate of missed LVH statements, whereas the recognition of the MI component was more often correct. In 146 cases with MIX MI, i.e., combined anterior and inferior localizations, the VCG and the combined ECG-VCG were significantly more accurate than the ECG along: 66% and 67% vs. 46%. Thus, in this category, computer-assisted interpretation of the VCG brings a clinically useful gain in diagnostic performance