Bert Vandenberk1, Tomas Robyns2, Griet Goovaerts3, Mathias Claeys2, Frederik Helsen2, Sofie Van Soest4, Christophe Garweg2, Joris Ector2, Sabine Van Huffel3, Rik Willems2. 1. Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; Department of Cardiology, University Hospitals Leuven, Leuven, Belgium. Electronic address: bert.vandenberk@kuleuven.be. 2. Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; Department of Cardiology, University Hospitals Leuven, Leuven, Belgium. 3. Department of Electrical Engineering (ESAT), STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, KU Leuven, Leuven, Belgium; Imec, Leuven, Belgium. 4. Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.
Abstract
BACKGROUND: Fragmented QRS (fQRS) on a 12-lead ECG has been linked with adverse outcome. However, the visual scoring of ECGs is prone to inter- and intra-observer variability. METHODS: Five observers, two experienced and three novel, assessed fQRS in 712 digital ECGs, 100 were re-evaluated to assess intra-observer variability. Fleiss and Cohen's Kappa were calculated and compared between subgroups. RESULTS: The inter-observer variability for assessing fQRS in all leads combined was substantial with a Kappa of 0.651. Experienced observers only had a better agreement with a Kappa of 0.823. Intra-observer variability ranged from 0.736 to 0.880. In the subgroup with ventricular pacing the inter-observer variability was even significantly larger when compared to ECGs with normal QRS duration (Kappa 0.493 vs 0.664, p<0.001). CONCLUSION: The visual assessment of QRS fragmentation is prone to inter- and intra-observer variability, mainly influenced by the experience of the observers, the underlying rhythm and QRS morphology.
BACKGROUND: Fragmented QRS (fQRS) on a 12-lead ECG has been linked with adverse outcome. However, the visual scoring of ECGs is prone to inter- and intra-observer variability. METHODS: Five observers, two experienced and three novel, assessed fQRS in 712 digital ECGs, 100 were re-evaluated to assess intra-observer variability. Fleiss and Cohen's Kappa were calculated and compared between subgroups. RESULTS: The inter-observer variability for assessing fQRS in all leads combined was substantial with a Kappa of 0.651. Experienced observers only had a better agreement with a Kappa of 0.823. Intra-observer variability ranged from 0.736 to 0.880. In the subgroup with ventricular pacing the inter-observer variability was even significantly larger when compared to ECGs with normal QRS duration (Kappa 0.493 vs 0.664, p<0.001). CONCLUSION: The visual assessment of QRS fragmentation is prone to inter- and intra-observer variability, mainly influenced by the experience of the observers, the underlying rhythm and QRS morphology.
Authors: Arjan Sammani; Rutger R van de Leur; Michiel T H M Henkens; Mathias Meine; Peter Loh; Rutger J Hassink; Daniel L Oberski; Stephane R B Heymans; Pieter A Doevendans; Folkert W Asselbergs; Anneline S J M Te Riele; René van Es Journal: Europace Date: 2022-10-13 Impact factor: 5.486
Authors: Bert Vandenberk; Matthias M Engelen; Greet Van De Sijpe; Jonas Vermeulen; Stefan Janssens; Thomas Vanassche; Peter Verhamme; Paul De Munter; Natalie Lorent; Rik Willems Journal: Int J Cardiol Heart Vasc Date: 2021-11-03
Authors: Amalia Villa; Bert Vandenberk; Tuomas Kenttä; Sebastian Ingelaere; Heikki V Huikuri; Markus Zabel; Tim Friede; Christian Sticherling; Anton Tuinenburg; Marek Malik; Sabine Van Huffel; Rik Willems; Carolina Varon Journal: Sci Rep Date: 2022-04-26 Impact factor: 4.996