TACHY - AN EXPERT-SYSTEM FOR THE MANAGEMENT OF SUPRAVENTRICULAR TACHYCARDIA IN THE ELDERLY

Purpose Many physicians find the management of supraventricular tachya rrhythmia (SVT) in the a derry complex aod challenging. With the use o f artificial intelligence theory, we developed an interactive computer expert system, TACHY, io recommend therapies and warn physicians of p otential therapeutic side effects. Methods we developed a knowledge ba se that stores guidelines for Ihs management of SVT in the elderly. Af ter the diagnosis of current SVT was input into the computer, TACHY ge nerated a list of therapeutic options as hypotheses, TACHY then prompt ed the user to provide current patient-specific clinical information, and the optimal therapeutic option was then selected. Potential therap eutic side effects were also displayed. TACHY was tested in a retrospe ctive and a prospective study. The retrospective study, comprising 96 patients with 126 episodes of SVT, was performed to determine the conc ordance of therapy between TACHY and cordiologists. A prospective stud y in 18 patients with 26 episodes of SVT was also performed to validat e TACHY's recommendations in restoring sinus rhythm, Results In the re trospective study the concordance between TACHY and the cardiologist's first therapeutic option was 95.9% (121 of 126 episodes), In the pros pective study sinus rhythm was restored in 18 (69%) of 26 episodes of SVT by the first therapeutic option recommended by TACHY, In the remai ning eight episodes use of the second or third suggestion of TACHY was successful in controlling the ventricular response to SVT. No adverse reaction to the therapeutic options suggested by TACHY occurred. Conc lusion TACHY, a knowledge-based computer expert system that simulates human decision making, produced promising results in the management of SVT in the elderly.