1052-2 Expert System Aid in Differentiating Among Paroxysmal Supraventricular Tachycardias

• Published in: Journal of the American College of Cardiology Vol. 25; no. 2; p. 181A
• Main Author: Georgeson, Steven
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.02.1995
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/0735-1097(95)92211-M

The differentiation between atrioventricular reciprocating tachycardia via an accessory pathway (AVRT) AV nodal reentrant tachycardia (AVNRT) and atrial tachycardia (AT) in paroxysmal supraventricular tachycardia may be helpful in guiding pharmacologic therapy and in identifying patients for radiofrequency catheter ablation. To help in this differentiation, an expert system was developed using a commercially-available expert system shell (EXSY'S). A simplified version of this system was designed to run on a palm-top computer. Both programs use the MS-DOS operating system. The expert system is rule-based and assigns probability values to the goal states through the process of backward chaining. The goal states for this expert system were AVRT, AVNRT, and AT. The user is queried for the presence of various abnormalities on the presenting EKG (P wave location, ORS alternans, pseudo r wave in lead V1, pseudo S wave in the inferior leads), comparison with previous EKG's (presence of pre-excitation) and the effect of vagal manueuvers or adenosine infusion on the tachycardia. From published data, each abnormality is assigned a probability based on the positive predictive value of the abnormality for AVRT, AVNRT and AT. By combining the positive predictive values, the expert system assigns a final probability for AVRT, AVNRT and AT. This expert system may be useful as a diagnostic tool and a teaching aid in the differentiation between AVRT, AVNRT and AT in paroxysmal supraventricular tachycardia.