Zhongwei Cheng1, Kang'an Cheng, Hua Deng, Taibo Chen, Peng Gao, Kongbo Zhu, Quan Fang. 1. Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China. Electronic address: zhongwei_cheng@hotmail.com.
Abstract
BACKGROUND: To distinguish left ventricular outflow tract (LVOT) from right ventricular outflow tract (RVOT) origin in idiopathic premature ventricular contractions or ventricular tachycardia (PVCs/VT) patients with transitional lead at V3 is still a challenge. We sought to develop a new electrocardiography (ECG) algorithm for distinguishing LVOT from RVOT origin in patients with idiopathic outflow tract PVCs/VT with precordial transitional lead at V3. METHODS: We analyzed the surface ECG characteristics in a retrospective cohort of idiopathic PVCs/VT patients with transitional lead at V3 who underwent successful radiofrequency catheter ablation and developed a new surface ECG algorithm, then validated it in a prospective cohort. RESULTS: A total of 82 consecutive patients (47 ± 17 years, 39% male) underwent radiofrequency catheter ablation of idiopathic outflow tract PVCs/VT between January 2006 and August 2010. Among them, 31 patients (38%) with transitional lead at V3 constituted the retrospective cohort. Based on the areas under the receiver operating characteristic curves, R-wave deflection interval in lead V3>80 ms and R-wave amplitude index in lead V1>0.30 were selected to develop the new surface ECG algorithm. It correctly identified the origin sites of eleven from 12 patients in the prospective cohort, yielding the accuracy of 91.7%. CONCLUSIONS: We presented a new simple surface ECG algorithm, R-wave deflection interval in lead V3>80 ms combining with R-wave amplitude index in lead V1>0.30 which can reliably distinguish LVOT from RVOT origin in idiopathic outflow tract PVCs/VT in patients with transitional lead at V3.
BACKGROUND: To distinguish left ventricular outflow tract (LVOT) from right ventricular outflow tract (RVOT) origin in idiopathic premature ventricular contractions or ventricular tachycardia (PVCs/VT) patients with transitional lead at V3 is still a challenge. We sought to develop a new electrocardiography (ECG) algorithm for distinguishing LVOT from RVOT origin in patients with idiopathic outflow tract PVCs/VT with precordial transitional lead at V3. METHODS: We analyzed the surface ECG characteristics in a retrospective cohort of idiopathic PVCs/VTpatients with transitional lead at V3 who underwent successful radiofrequency catheter ablation and developed a new surface ECG algorithm, then validated it in a prospective cohort. RESULTS: A total of 82 consecutive patients (47 ± 17 years, 39% male) underwent radiofrequency catheter ablation of idiopathic outflow tract PVCs/VT between January 2006 and August 2010. Among them, 31 patients (38%) with transitional lead at V3 constituted the retrospective cohort. Based on the areas under the receiver operating characteristic curves, R-wave deflection interval in lead V3>80 ms and R-wave amplitude index in lead V1>0.30 were selected to develop the new surface ECG algorithm. It correctly identified the origin sites of eleven from 12 patients in the prospective cohort, yielding the accuracy of 91.7%. CONCLUSIONS: We presented a new simple surface ECG algorithm, R-wave deflection interval in lead V3>80 ms combining with R-wave amplitude index in lead V1>0.30 which can reliably distinguish LVOT from RVOT origin in idiopathic outflow tract PVCs/VT in patients with transitional lead at V3.
Authors: Jianwei Zheng; Guohua Fu; Islam Abudayyeh; Magdi Yacoub; Anthony Chang; William W Feaster; Louis Ehwerhemuepha; Hesham El-Askary; Xianfeng Du; Bin He; Mingjun Feng; Yibo Yu; Binhao Wang; Jing Liu; Hai Yao; Huimin Chu; Cyril Rakovski Journal: Front Physiol Date: 2021-02-25 Impact factor: 4.566
Authors: Michael Efremidis; Konstantinos Vlachos; Maria Kyriakopoulou; Panagiotis Mililis; Claire A Martin; George Bazoukis; Stylianos Dragasis; Athanasia Megarisiotou; Philippe Unger; Antonio Frontera; Giuseppe Mascia; Athanasios Saplaouras; Sotirios Xydonas; Kosmas Valkanas; Frédéric Sacher; Pierre Jaïs; Konstantinos P Letsas Journal: Heart Rhythm O2 Date: 2021-08-02