Multiple Intercostal Space Electrocardiogram Allows Accurate Localization of Outflow Tract Ventricular Arrhythmia Origin.
Pacing Clin Electrophysiol
; 39(2): 173-81, 2016 Feb.
Article
em En
| MEDLINE
| ID: mdl-26549840
ABSTRACT
BACKGROUND:
Multiple intercostal recordings were supposed to get a more comprehensive view of the depolarization vector of the outflow tract ventricular arrhythmia (OT-VA), which may help to identify the OT-VA more accurately. This study was undertaken to develop a more accurate electrocardiogram (ECG) criterion for differentiating between left and right OT-VA origins.METHODS:
We studied OT-VA with a left bundle branch block pattern and inferior axis QRS morphology in 47 patients with successful catheter ablation in the right ventricular OT (RVOT; n = 37) or aortic coronary cusp (ACC; n = 10). Superior and inferior precordial leads were taken together with the routine 12-lead ECG. The ECG during the OT-VA and during sinus beats were analyzed. Transition ratio, transition zone (TZ) index, R/S amplitude ratio, and R-wave duration ratio were measured in the regular, superior, and inferior precordial leads.RESULTS:
The combined TZ index, TZ index inferior was significantly smaller, while the V2 inferior transition ratio was significantly larger for ACC origins than RVOT origins (P < 0.05). The area under the curve for the combined TZ index by a receiver operating characteristic analysis was 0.974, which was significantly larger than other parameters. A cutoff value ≤0.25 predicted an ACC origin with 94% sensitivity and 100% specificity. This advantage of the parameter over others also held true for a subanalysis of OT-VAs with a lead V3 precordial transition or TZ index = 0.CONCLUSIONS:
The combined TZ index outperformed other ECG criteria to differentiate left from right OT-VA origins.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Arritmias Cardíacas
/
Eletrocardiografia
/
Ventrículos do Coração
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article